Recent research from the Cleveland Clinic indicates that bariatric surgery might be more effective in preserving kidney function in individuals with obesity, diabetes, and chronic kidney disease compared to GLP-1 drugs. The study reveals that bariatric surgery significantly slows the progression of kidney disease, potentially offering a more robust solution than current pharmacological treatments.
Study Overview
The study, published in Annals of Surgery, tracked 425 participants over a median period of 5.8 years. Of these, 183 underwent bariatric surgery while 242 were treated with GLP-1 drugs, which are also used for weight management. The results show that bariatric surgery was associated with a 60% reduction in the risk of kidney impairment progression and a 44% reduction in the risk of kidney failure or death.
Impact of Obesity and Diabetes on Kidney Health
Obesity significantly strains bodily organs and increases the likelihood of developing type 2 diabetes, which can, in turn, lead to chronic kidney disease—a major cause of diabetes-related mortality. Bariatric surgery, including procedures like gastric sleeve surgery, reduces the stomach size by approximately 80%, leading to improved metabolic outcomes such as reduced hunger and significant weight loss. This surgery not only aids in weight loss but also mitigates the factors that exacerbate kidney disease.
Current Treatment Options and Their Limitations
Although GLP-1 drugs are known to aid in weight management and diabetes control, they do not induce the same metabolic changes as bariatric surgery. Dr. Raj Dasgupta, chief medical advisor for Fortune Recommends Health, notes that while bariatric surgery is increasingly considered for severe obesity combined with diabetes and kidney disease, it is not yet the first-line treatment. Insurance coverage for such surgery typically requires a BMI of 35 to 40, although some recent studies suggest that lower BMI thresholds could also be effective.
Metabolic Changes from Bariatric Surgery
The metabolic benefits of bariatric surgery are significant. By reducing the stomach’s size, the procedure lowers the production of hunger-stimulating hormones like ghrelin. This reduction helps patients feel full with less food, supporting long-term weight loss and improving overall health. According to Dr. Mir Ali, a bariatric surgeon, these hormonal changes can lead to better diabetes control and consequently benefit kidney health.
Durability of Weight Loss
Weight-loss surgery also offers more durable weight loss compared to diet and exercise alone. Studies indicate that long-term success rates for surgery are around 80%, compared to only 2–5% for non-surgical weight management methods. While the long-term efficacy of GLP-1 drugs is still under evaluation, it is expected to be less effective than surgical options.
In conclusion, this study underscores the potential for bariatric surgery to provide superior kidney health benefits over GLP-1 medications, particularly for those with severe obesity and chronic kidney disease.
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