I asked my PCP, transplant team and even other specialists if using Wegove or Zebound would help my weight issue, I have put on a good 20-25 pounds since transplant and can’t get off of that weight.
Did any of you have weight issues? How did you deal with it? (For me, since I’m on steroids, nothing seems to help). Have any of you used Wegove or Zebound? What side effects did you face if you took it and which one did you take.
As always….thanks for your advice. Take care and keep healthy.
Weight gain with steroids is unfortunately normal. I was on them for about a year and I got moon face and gained 30lbs that I couldn't shift for the life of me.I eventually came off them and the weight started coming off and my face went back to normal.
Post transplant gain was something else. You spend so long losing weight and restricting your lifestyle in the lead up to a transplant because of your failing kidneys, that usually once you get the all clear you go a little wild without noticing. My appetite increased, I could have potato again, my doctors actually told me to eat more phosphate rich food (processed food and carbs) because where my kidney was working my levels were too low. Plus you take a ton of drugs that cause all sorts of side effects that make weight gain kind of inevitable at first.
Given how new these weight loss drugs are to the market I'd doubt they've been effectively tested in people who have had transplants so I'd be really surprised if anyone can give you reliable long term data on safety and effectiveness.
It's not the advice you're looking for but I was young when I had my first transplant (26) and I made the personal decision that I could live being a little chubby knowing I was well. If you want to really lose weight with drugs then I wish you the best but personally I'd really consider the risks that come with trying a new medication to change something that is mostly cosmetic.
Thank you so much. I am on the fence about it all. I have checked with the transplant team, my PCP (who recommended it), my cardiologist who gave it a thumbs up and waiting to hear from my regular nephrologist. I have sort of had the same attitude that if I'm chubby, oh well, I'm chubby. It gets frustrating though when pants don't fit. I will say that I don't like the way I look. I coached for 30 years and always prided myself in being fit and looked pretty good. Now I don't quite feel that way. I may try it and if I have side effects, then stop it. Again just trying to make the best decision. Again thanks so much ! Wishing you all the best.
I have struggled with my weight my entire adult life. Finally was at stable weight for about 8 years. Obese but only slightly.
At my transplant evaluation I will never forget the surgeon said, “ I want you to lose weight now because after transplant I put my patients on steroids and they gain 15 to 20 pounds .” I went home and cried. Like I had never tried before?
Sure enough after transplant I gained weight. Steroids both make you hungry and alter metabolic pathways in your body, raising blood sugar.
All except one transplant patient I know have had weight gain.
20 % of all transplant patients become diabetic. I became prediabetic.
My transplant nephrologist recommended either the injectable weight loss drugs or gastric sleeve.
I never wanted to have weight loss surgery. It’s drastic and several people I know who have had it gain the weight back.
Meanwhile I watched both my brothers become diabetic. They lost weight and one is no longer diabetic, one is back to prediabetes.
I was scared of side effects but decided I couldn’t ignore the risk to my health, so I started zepbound a month ago and have lost 11 pounds. It’s like a miracle to not feel hungry much. Did I have nausea? Yes but it was very mild. I don’t have violent vomiting, did not get pancreatitis as I feared.
Zepbound prevents pre diabetes from becoming diabetes in over 90% of patients. Of course we don’t know about people taking prednisone.
My nephrologist said some of his transplant patients are on it.
I fully intend to stay on it for life, but we will see what happens, if no other side effects get worse as I increase dosage.
They are coming out with a pill next year I believe.
I don’t mind injecting myself I used to do it before I was on dialysis.
Highly recommend it!
Thanks so much! My wife is a retired nurse practitioner so hopefully she will have a good eye on me if I start taking it. Was there a reason to us Zebound vs. Wegovy? Just curious. Again thanks and wishing you all the best for 2025
Zepbound is more effective than wegovy. It has two medicines. Wegovy has only one.
Hi,
I was on dialysis for 8 years before my transplant and got very thin . I never struggled with my weight before I got sick. I was a perfect weight for 40 years. Then I was transplanted and started steroids, the first 2 years I put on 18kgs had to throw out all my clothes , it was really hard getting use to my new body . I became so insecure. So I understand completely. I ended up getting steroid diabetes and was put on medication, I didn’t realise there was a mild weight loss ingredient in it and I slowly start losing the weight. 5 years on I’m happy enough. I don’t know any of those drugs I’m in Ireland but do lots of research and do what’s going to make you happier in life.
Good luck
Hi, Tankjsl. I didn't have a weight problem but I did develop diabetes after my transplant, so one of the meds my team gave me for that is Rybelsus. Within the first several months, I lost around 20 pounds. It's a pill, not a shot. I'm 7 years post.
These GLP-1 medications are discovering new side effects every few weeks. I am not a medical professional but based on what I have heard from peers at healthcare companies, there are new studies that show GLP-1 medications have increased risk for kidney damage. I would push your medical team to confirm it is truly safe for you before you consider it.
Your primary care doctor recommended it, your cardiologist is also on board and you are checking with your nephrologist - all good to get opinions from multiple docs that know you. They are the ones most knowledgeable about the specific health risks to you about carrying extra weight vs getting the weight off. Bonus that your wife is an NP. Best of luck to you whatever is decided.
Hi Tankjsl
Full disclosure: I oversee drug development for a pharmaceutical company specializing in kidney and metabolic diseases. This post builds on a discussion I shared last year about Wegovy, and I’ll summarize that information here. Please note that this is my own opinion and definitely not medical advice.
In short, these medications work. I’ve been taking Ozempic since October 2022 and have lost about 45 pounds. As a transplant patient on steroids for 20 years, I gained significant weight, but my primary concern was managing diabetes. However, many patients who start these medications eventually stop taking them and regain the weight. This happens for two main reasons: cost and side effects. These drugs are extremely expensive, and for insurance to cover them, they need to be coded as treatment for diabetes. In my case, my endocrinologist determined I should be on this medication due to the effects of long-term prednisone use. There is a specific ICD-10 code for post-transplant-induced type 2 diabetes, which allowed me to qualify for coverage. My endocrinologist also noted that transplant patients like us often have a different profile than typical diabetics. We almost never have high fasting blood glucose levels, and the elevated levels appear later in the day, when blood sugars spike into the 200–300s and take more than 2–3 hours to return below 180.
Additionally, side effects cause many people—about 40–50% of patients—to discontinue the medication within 24 months. When starting GLP-1 drugs like Ozempic, it’s common to experience nausea, vomiting, and diarrhea. These side effects can lead to dehydration and, in severe cases, acute kidney injury (AKI) if not treated promptly. Personally, I’ve been to the emergency room twice while on Ozempic because I ate foods I should have avoided, resulting in severe vomiting and diarrhea. As a transplant patient, I recognized the signs of dehydration early and received fluids quickly, which helped me avoid AKI. After six months on my highest dose, the side effects completely disappeared. These medications require time for the body to adjust, often several months. Unfortunately, many people don’t allow enough time and fail to make dietary changes that could minimize these problems.
It’s important to remember that all drugs have side effects, and we must weigh the risks and benefits. We do the same thing with our immunosuppressants, which have serious and sometimes life-altering effects. However, for those of us who choose to have a transplant, we understand that it’s better than the alternatives—dialysis or death. GLP-1 drugs, like immunosuppressants, are not without challenges, but for many, the benefits outweigh the risks.
There is strong evidence supporting the benefits of these drugs. A clinical trial conducted last year on patients with type 2 diabetes and chronic kidney disease (CKD) was ended early because of overwhelmingly positive results. Patients showed improved kidney function and better diabetes control. Furthermore, publications from multiple transplant centers have reported success with these drugs for post-transplant weight loss and diabetes management. They are also being used as a safer alternative to gastric bypass surgery, which has severe, expensive, and often irreversible side effects.
From my own experience, I’ve seen significant health improvements. My creatinine levels dropped from 1.8 to 1.5, my lipid panels improved, and my overall health has greatly benefited. According to my endocrinologist, GLP-1 drugs effectively reverse some of the long-term side effects of prednisone.
I hope this information helps!
It is also important to make sure patient intakes adequate protein in their diet while on it.
Tankjsl, I can understand your concerns. So I guess I’ll share my situation.
I am 24 months post transplant. My donor kidney is a rock star! Creatinine .88 with GFR72. This is with severe CMV issues that lasted close to 11 months (thankfully finally resolved) and a T-LGL leukemia diagnosis in early December 2023. My journey has been a little stressful.
Through all of this I kept gaining weight even when quite ill with CMV! I’ve had sufficient loss of bone density to be placed on Fosamax this past month. My joints are in distress from the weight gain. I had Type II but managed it without medication for over 13 years pre-transplant with my A1Cs ranging from 5.3 to 5.4… Post-transplant I was immediately put on insulin. I administered long lasting insulin at night and fast acting insulin before meals.
My endocrinologist just pulled me off all insulin this week. In short I was experiencing numerous severe low glucose crashes daily (5-6 a day as low as 40 or lower for glucose readings). He kept lowering does for both meds. For the past month I was no longer taking any long lasting insulin and only administering 1 unit if fast acting insulin for every 40 carbs per meal. That meant only 1 unit of insulin per meal. I was still experiencing low glucose problems. So I then shifted to administering fast acting insulin only once a day with lunch. This was specifically because I experienced elevated glucose mid afternoon exactly as Redpanda67 described.
Meanwhile my podiatrist contacted the transplant center to discuss my joint strain and “crumbling” bones due to the loss of bone density and huge weight gain (38lbs) post-transplant. She planned to begin treatment for bone density and discussed the need for medication to support weight loss. In addition, my endocrinologist was ready to pull me off insulin and try a different treatment approach for my Type II.
So, I started taking Ozempic based upon the transplant center’s recommendation. I’m in my 5th week with that medication. I also started Fosamax 2 weeks ago. Ozempic is used specifically to support Type II with me and promote weight loss. Fosamax is to address bone density issues. I’m being fitted for a permanent custom made ankle AFO. This will relieve strain in my right ankle and allow me to walk 2-3 miles a day again.
My transplant nephrologist told me to be sure to drink lots of water while taking ozempic and to contact her immediately if I experience vomiting or diarrhea. My endocrinologist emphasized lots of fluid and eating plenty of protein. The pharmacist told me to stay away from processed foods, baked goods or other surgery high glucose foods as well as fatty foods. So far I’ve experienced minimal cramping after eating 2-3 times a week which is followed by a loose stool but not diarrhea. In the first 5 weeks on ozempic at low starting doses I’ve lost 6 pounds. It is definitely decreasing the incessant hunger from prednisone. But it is important to eat a healthy diet and exercise to get full benefit from the medication. I’m no longervexperiencin low glucose since discontinuing insulin and relying on ozempic alone for Type II management.bi still use my libre3 monitor so can see that my glucose readings are clustering around 100 (range 92-135) they elevate to around 135 2 hours after eating but then decrease back to normal range 40-65 minutes later. I’ve also fund that doing 25-30 minutes moderate exercise using my NeuStep at about 2:30pm helps minimize the mid-afternoon glucose elevation.
So that’s my situation.
Jayhawker
Preemptive kidney transplant experience and results
Lost weight and feel great
would like to hear about kidney transplant experiences please
Preventing hair loss post transplant
