A recent study conducted at the Cleveland Clinic found that bariatric surgery, also known as gastric sleeve surgery, is more effective at reducing the progression of chronic kidney disease in individuals with obesity and diabetes compared to treatment with GLP-1 drugs. Chronic kidney disease often arises as a result of type 2 diabetes, which is more common in individuals with obesity. Bariatric surgery not only reduces the size of the stomach but also triggers metabolic changes that decrease hunger in individuals, making it easier for them to lose weight and manage their conditions.
The study involved 425 participants who were either treated with bariatric surgery or GLP-1 diabetes drugs. The individuals who underwent surgery had a 60% lower risk of kidney impairment progression and a 44% lower risk of kidney failure or death compared to those who received drug treatment. The surgery involves reducing the size of the stomach by about 80%, which results in individuals feeling full with less food and experiencing reduced feelings of hunger. These changes ultimately lead to successful weight loss, which is a key factor in managing both kidney disease and diabetes.
Obesity is a condition that can put stress on all of the body’s organs and increase the risk of type 2 diabetes. Poorly controlled diabetes can also negatively impact kidney health, leading to chronic kidney disease. While obesity and diabetes are common contributors to chronic kidney disease, there are other genetic and lifestyle factors that can also lead to the condition. Bariatric surgery is not typically the first choice for individuals with obesity and kidney disease, but it is becoming more common, especially for those with severe obesity and diabetes.
Insurance coverage for bariatric surgery typically requires individuals to have a body mass index (BMI) between 35 and 40 and no other medical conditions. Despite evidence showing that the criteria for coverage could be adjusted to make surgery more accessible to a wider range of individuals, insurance companies have not updated their requirements. GLP-1 drugs can help control diabetes and aid in weight loss, which can benefit kidney health without the need for surgery. These medications do not produce the same metabolic changes as bariatric surgery, but they can still be effective in managing conditions for some individuals.
The metabolic changes induced by bariatric surgery play a crucial role in improving overall health and protecting the kidneys by controlling diabetes and other factors that can cause damage. Surgical procedures such as gastric sleeve and bypass alter digestion and hormone production in the stomach, reducing hunger and facilitating weight loss. While the long-term success of GLP-1 drugs is still being studied, bariatric surgery has been shown to result in significant weight loss that is often maintained for many years. This success rate far surpasses that of diet and exercise alone, making surgery a more sustainable option for individuals with obesity and associated health conditions.
