Bariatric surgery may lower risk for severe liver disease, new study finds

One in four American adults has fatty liver disease caused by obesity, not drinking, and there is no medical treatment for it. Doctors say the only way to keep it in check is to lose weight and eat a healthier diet.

>> Roni Caryn RabinThe New York Times
Published : 11 Nov 2021, 06:41 PM
Updated : 11 Nov 2021, 06:41 PM

Now a new study reports that bariatric surgery, in addition to helping with weight loss, can protect the liver. The findings were striking: Of a group of more than 1,100 patients who had an aggressive form of fatty liver disease, those who had weight loss surgery cut their risk of advanced liver disease, liver cancer or related death by almost 90 percent over the next decade.

Only 5 of the 650 patients who had bariatric surgery later developed one of those severe liver outcomes, compared with 40 of 508 patients who did not have the procedure.

The weight loss surgery patients were also at significantly lower risk for cardiovascular disease, a finding that is consistent with earlier research. They were 70 percent less likely to experience a cardiac event, stroke or heart failure, or to die of heart disease, according to the study published Thursday in JAMA.

Dr Ali Aminian, director of the Cleveland Clinic’s Bariatric and Metabolic Institute and the study’s lead author, said that in all likelihood weight loss had stopped the disease in its tracks.

“Obesity is the main driver of the fatty liver; it all starts with obesity,” Aminian said. “When we have excess fat that accumulates in the liver, it causes fatty liver. Then inflammation comes and gets worse, and then scar tissue forms and leads to cirrhosis.

“When a patient loses weight, fat goes away from everywhere, including the liver; inflammation subsides, and some of the scar tissue can reverse and get better,” Aminian continued. “Weight loss is the main factor here.”

The surgery carries serious risks, however. Sixty-two of the 650 weight loss surgery patients in the study group developed serious complications after the operation, and four of them died within a year of having the operation.

There are no approved drugs or therapies available for nonalcoholic fatty liver disease. Doctors generally advise patients to lose weight and to switch to a healthier diet.

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