November 4, 2025

New study explores why losing weight is so hard with kidney disease

People living with chronic kidney disease (CKD) experience high rates of obesity, which can worsen kidney health and, in some cases, affect a person’s eligibility for a kidney transplant. Obesity also raises the risk of complications after surgery and reduces long-term graft survival.

To better understand these challenges, Dr. Louise Moist and her colleagues at Western University in London, Ontario, interviewed 12 people living with advanced CKD and obesity (defined as a Body Mass Index over 30). The goal was to explore their experiences, knowledge, and strategies related to weight management. The findings highlight ways health care providers can better support patients in reaching their weight loss goals.

Many study participants said they had never had meaningful conversations about weight loss with their care providers. When information was offered, it was often limited to general suggestions around diet and exercise—which authors note can be unhelpful for people with advanced CKD who have specific nutritional and physical activity needs.

Participants also described trying various diets in the past, which typically led to short-term weight loss and were not sustainable long-term. The effect of emotions on eating habits was a recurring theme; with many participants saying they tended to eat more when feeling sad.

The researchers note that people with CKD often experience anxiety and depression, which can make lifestyle changes harder. Integrating stress management techniques into care could improve long-term success with diet and exercise. Participants also mentioned internal and external motivators—such as fears about losing transplant eligibility or developing other health complications related to obesity—that influenced their efforts.

Overall, the study points to the need for personalized, multi-faceted weight management programs for people with advanced CKD. The authors say such programs should combine nutrition and exercise counselling with support for behavioural modification and, where appropriate, access to anti-obesity medications.