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If you are considering going on a diet to lose weight, you may wonder how that will work with your dialysis diet. As with most diets, losing weight on a dialysis diet can be challenging and take time to show results. If you diet in a healthy way by eating right, working with your renal dietitian and incorporating physical activity into your routine, you can lose the unwanted pounds and feel healthier.
If you are overweight or obese and on dialysis, you may benefit from weight loss for the following reasons:
There are some things to know before you begin any weight-loss plan. When you’re on dialysis, talking with your dietitian and doctor about changes in your usual diet is important. Your dietitian can help you form a meal plan that keeps in mind both your dialysis diet and your desire to lose weight, while your doctor may suggest which exercise is best for you. Share with them what your goals are so that you receive accurate guidance for your weight-loss diet.
The following are weight-loss diet tips for people on dialysis:
Be aware of your shopping and eating habits
Exercise with your doctor’s consent
Reduce calorie and fat intake
Be aware of your portion sizes
Carbohydrates (grains, starches)
1 cup = size of an adult’s fist
Protein (meat, fish, poultry)
3 ounces = size of the palm of your hand
Fats (butter, salad dressing, etc.)
1 teaspoon = a thumb tip
Fruit and vegetables
1/2 cup = size of a small fist
When you set reasonable goals and achieve them, reward yourself. Here are some suggestions:
Weight loss can be difficult. It takes time and dedication to achieve your weight-loss goals. The difficulties you may face are both physical and emotional. Here are some reasons why dialysis patients may be deterred from eating right and exercising.
Some people with chronic kidney disease (CKD) who are on dialysis have anemia, due to low red blood cell count, which causes fatigue, shortness of breath and dizziness. Your doctor will develop a treatment plan that will help treat anemia. If you have anemia, ask your doctor to tell you when your blood count is high enough for you to exercise safely.
Some dialysis patients who do in-center hemodialysis can feel weak after treatment and therefore lack the motivation to exercise. Sometimes this will last for only a few hours while others require a good night's sleep. Plan exercise after a post-treatment rest or exercise on non-dialysis days.
Peritoneal dialysis (PD)
People on peritoneal dialysis (PD) may have trouble losing weight because they absorb glucose (sugar) from the dialysis solution. The glucose taken in during dialysis can sometimes add up to as much as 500 calories per day. The best way to avoid weight gain while on peritoneal dialysis is by using dialysis solutions with the least amount of glucose. That means using more 1.5% and 2.5% (yellow) bags and fewer 4.25% (red) bags. If this results in the retention of fluid, work with your dietitian and PD nurse to determine the amount of salt and liquids you should eat and drink each day.
People on PD usually have the time and ability to exercise, and this should be a part of your daily routine. Some people find it easier to exercise with an empty abdomen rather than one filled with fluid. This should be discussed with your PD nurse and physician.
Reducing food intake usually cuts into the amount of protein eaten. If high-quality protein intake is inadequate while dieting, you may lose muscle mass and your albumin level may drop. Your dietitian can offer guidance to help make sure you eat enough low-fat, high-quality protein. Dietitians can also monitor your monthly labs to make sure your albumin is not dropping.
Sometimes people make poor food choices based on their emotional state and overeat when they feel down, hopeless or even happy and want to celebrate.
Remember that losing weight will not happen overnight and trying to make huge changes all at once can become discouraging. Set small goals that can turn into an overall big success.
Talk with your dietitian about different meal plans that fit your goals and lifestyle. Your dietitian may also introduce you to frozen meals that cut cooking time but are low in phosphorus and potassium. Be sure to cut out unnecessary calories, such as high-fat and high-sugar foods. If you find yourself losing weight to be on the transplant list, this shows the healthcare team how committed you are to your health.
People who are successful at losing weight usually adopt the following habits:
Let your healthcare team know that you are trying to lose weight. Your dry weight needs to be adjusted as you lose weight so the correct amount of fluid is taken out during each treatment.
Weight-loss dieting when you’re on dialysis can be an added challenge to the dialysis diet. Losing weight does not happen overnight and requires a lot of dedication. Gradual changes may help you achieve better results. The approach is not just a change in your diet, but a change in your lifestyle. Once you set realistic weight-loss goals, talk with your health care team about an individualized plan and making good habits as part of your routine. You may end up a weight-loss success story.
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