Clinician - Obesity Infographic

Management of Obesity in Persons Living with CKD

The CKD-Obesity Connection

Obesity increases the risk of CKD progression, worsens quality of life, and complicates management when both exist. Though not traditionally managed by the kidney care team, addressing obesity is key to holistic, person-centered care.

Start the Conversation

Clinicians often avoid discussing obesity to prevent embarrassment, yet patients want more guidance, especially on conflicting nutritional advice, goal-setting, and treatment options.

Person-first Language

Avoid Stigmatizing Terms

Use Positive or Neutral Framing

A Holistic Approach to Obesity in CKD

Obesity Treatments

Nutrition for Obesity

Refer patients to a dietitian for medical nutrition therapy (MNT) and personalized guidance – emphasizing MNT is more than just “what to eat”.

The presence of CKD can complicate obesity medication treatment. Click below for a summary of approved treatments with key points for use in CKD.

General Nutrition Guidance

Medication Considerations

Supported by

References

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Information contained in this NKF educational resource is based on data available at the time of publication. It is intended to help clinicians stay informed about new scientific findings and developments. This resource is not intended to establish a preferred standard of care and should not be interpreted as prescribing an exclusive course of management.

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Obesity Pharmacotherapy Overview for Patients with CKD

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References

• Alp IT, Kramer HJ, Srinivasan B, et al. ASN Kidney Health Guidance on the Management of Obesity in Persons Living with Kidney Diseases. J Am Soc Nephrol. 2024;35(11):1574-1588. DOI: 10.1681/ASN.0000000512.

• Anderson S, Benitez E, Gonzalez-Godinez E, Desai Y, Heer N, White J. Beyond BMI: a patient-centered approach to discussing obesity. Methodist Debakey Cardiovasc J. 2025;21(2):94-96. DOI: 10.14797/mdcvj.1531.

• Auckburally S, Davies E, Logue J. The use of effective language and communication in the management of obesity: the challenge for healthcare professionals. Curr Obes Rep. 2021;10(3):274-281. DOI: 10.1007/s13679-021-00441-1.

• Kaesler N, Fleig S. Ten tips on how to manage obesity in the presence of CKD. Clin Kidney J. 2024;17(11):sfae317. DOI: 10.1093/ckj/sfae317.

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Talking with your patients about weight. August 2023. Accessed September 2, 2025. https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/weight-management/talking-with-your-patients-about-weight.

• O’Shea D, Kahan S, Lennon L, Breen C. Practical approaches to treating obesity: patient and healthcare professional perspectives. Adv Ther. 2021;38(7):4138-4150. DOI: 10.1007/s12325-021-01748-0.

• Puhl RM. What words should we use to talk about weight? A systematic review of quantitative and qualitative studies examining preferences for weight-related terminology. Obes Rev. 2020;21(6):e13008. DOI: 10.1111/obr.13008.

• Vallis M, Piccinini-Vallis, H, Sharma AM, Freedhoff Y. Modified 5 As: Minimal intervention for obesity counseling in primary care. Can Fam Physician. 2013;59(1):27-31.

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• Emphasize a personalized approach
• Choose water over sweetened drinks
• Encourage slow and mindful eatingPrioritize plant-based, fiber-rich foods; limit ultra-processed foods
• Support physical activity with adequate protein to maintain muscle and prevent sarcopenia/malnutrition
• Avoid broad restrictions - nutrition absorption (e.g. potassium, phosphorus) varies by food
• Share the NKF Nutrition Hub resource with your patients

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• Emphasize a personalized approach
• Choose water over sweetened drinks
• Encourage slow and mindful eating
• Prioritize plant-based, fiber-rich foods; limit ultra-processed foods
• Support physical activity with adequate protein to maintain muscle and prevent sarcopenia/malnutrition
• Avoid broad restrictions - nutrition absorption (e.g. potassium, phosphorus) varies by food
• Share the NKF Nutrition Hub resource with your patients