News from Cedars Sinai

Three Kidney Transplants, Weight Gain and a Journey Back to Wellness

Rowena Roque, 46, was having a problem that many people can relate to: doing everything in her power to lose weight and get healthy but never succeeding.

From fad diets to two-hour workouts, there isn’t a diet or workout regimen that Roque didn’t try. 

“My weight challenges have been an issue my entire life,” said Roque. “I’ve probably tried every diet program out there.”

Roque, a registered nurse, says her health obstacles began long before adulthood.

At 15, she was diagnosed with immunoglobulin A nephropathy, a chronic kidney disease that would lead to kidney failure. Ultimately, she needed a kidney transplant.

Over a span of 20 years, her body endured dialysis, steroid medications, major stress and two kidney transplants–all contributing factors to her ongoing struggle with weight gain.

In 2020 Roque underwent her third kidney transplant at Cedars-Sinai Comprehensive Transplant Center.

My ultimate end goal is to be healthy,” said Roque. “I am not doing this weight loss journey to look a certain way or to be super skinny or look like a supermodel. My goal is to be healthy so that my third kidney transplant will hopefully be my last.”

Determined to keep her kidney healthy, Roque knew she would have to keep her blood pressure low and reduce her body mass index (BMI), so she kicked her healthy habits into overdrive.                                                                                           

Roque spent the next year and a half counting calories, eating three wholesome meals a day and exercising five days a week. Her workout routine consisted of walking 10,000 steps a day, weight training and cardio exercises.

The scale didn’t move.

Concerned that something was wrong, Roque reached out to her network of doctors, family, and friends, but no one could diagnose what was happening. Some didn’t believe her when she explained her weight loss efforts.

“I turned to several doctors who just gave me different answers, such as, ‘Maybe your body just likes that weight,’ or, “Maybe you just need to try harder,’” said Roque. “It wasn't until I spoke to one of my transplant physicians at Cedars-Sinai, who recommended I go see Dr. Velazquez.”

Amanda Velazquez, MDAmanda Velazquez, MD, director of Obesity Medicine in the Department of Surgery at Cedars-Sinai, says Roque’s story is not unique.  

“There is severe stigma around obesity,” said Velazquez. “Individuals are often thought to lack willpower and assume that is what got them to where they are with their weight, when that is not true. What's really happening is they could be up against a severe chronic disease–obesity–that is very complex.”

Obesity is an epidemic in the United States, with 42% of adults having a BMI over 30, according to the Centers for Disease Control and Prevention. This number is predicted to rise to 50% in 2023.

A BMI of 18.5-25 is regarded as healthy, and one between 25 and 30 qualifies as overweight.

“Rowena had been trying her hardest for years to try to help herself lose weight to improve her health and preserve the health of her kidney. But despite her good efforts, her body had a propensity for her weight to keep going up,” said Velazquez.

With weight gain primarily in her abdominal area and a BMI of 35.7–putting Roque at a greater risk for heart disease and other metabolic complications–Velazquez diagnosed Roque with obesity and prescribed semaglutide.

Semaglutide, sold under the brand names Ozempic and Wegovy, is a medication available for the treatment of type 2 diabetes and obesity, respectively, that can help patients lose and maintain weight loss.

This class of weight management medications works by imitating a gut hormone called glucagon-like peptide, or GLP1, that helps people feel fuller and reduces appetite.  

Since beginning her weight loss journey with Velazquez, Roque has lost over 25 pounds and to date has lowered her BMI to 29.

“The results have been pretty amazing,” said Roque. “I am putting in the same amount of work and discipline that I was already doing a year and a half ago. The difference is that I’m now losing weight thanks to weight management medications.”

Nutrition, exercise and a healthy lifestyle are essential to complementing weight loss medications.

Today Roque’s routine includes working out five days a week, walking at least two miles a day and enjoying a balanced diet filled with protein, fruits and vegetables.

“We recognize and understand that obesity is complexthe body is working against youso we get that it is hard to lose weight,” said Velazquez. “Therefore, we want individuals to feel empowered to seek out care because these tools can help you to lose the weight and improve your overall health.”

To learn more about weight loss medications, talk to your healthcare team or contact the Cedars-Sinai Center for Weight Management and Metabolic Health.

Read more from the Cedars-Sinai Blog: Weighing In on Weight Loss Drugs