Dr. Stanford’s Follow Up Questions and Answers

Obesity: Understanding the Disease in the Context of Patients with Kidney Disease

Dr. Fatima Cody Stanford, M.D.

Obesity: Understanding the Disease in the Context of Patients with Kidney Disease

In response to the questions asked on Thursday, November 15, 2018 at the 2018 Renal Care Symposium. 

1. How to manage weight going into menopause.

This question requires a long response. 

I would take a look at this lecture that I gave on this topic:

https://www.massgeneral.org/about/news/multimedia.aspx?id=1061

 *Please note-the response to the question asked begins at the 15:00 mark. 

2. Are there studies of weight loss medications for patients with kidney disease. What is the impact on residual kidney function?

Many of the weight loss medications do not have any negative impact on the kidney and could be utilized long term. However, drugs like topiramate and zonisamide may predispose to nephrolithiasis. As a result, we may have to stop these medications if that becomes an issue.

 

3. What are your opinions / thoughts on ketogenic diet, and how ketosis affects the hormonal metabolism/ metabolic changes?

The only medical condition in which the long term impact of the ketogenic diet has been evaluated is refractory seizure disorder. As a result, I do not recommend this for weight regulation as there are no long term studies which point to it utility for long term weight regulation. 

 

4. For swing shift and night shift workers who cannot change jobs, what options do patients have if lack of sleep interferes with managing a healthy weight?

I would minimize other factors that may affect weight regulation such as the amount of screen time (aim for less than 2 hours) and maximize diet quality (lean protein, whole grains, vegetables, and fruits), ensure at least 150 minutes of moderate intensity physical activity, and minimize stress.

 

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