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• Posted January 30, 2025

Weight-Loss Surgery Protects Liver Health

Weight-loss surgery can protect the liver health of patients with obesity and fatty liver disease, a new study reports.

Patients had a 72% lower risk of developing serious complications of liver disease after undergoing weight-loss surgery, researchers reported in Jan. 27 in the journal Nature Medicine.

They also had an 80% lower risk of their liver disease reaching an advanced, life-threatening stage, researchers found.

These results show that the sort of weight loss associated with bariatric surgery can make a major difference in people with fatty liver disease, also called metabolic dysfunction-associated steatohepatitis (MASH), researchers said.

“Currently, lifestyle intervention (diet and exercise) is the only therapeutic recommendation for compensated MASH-related cirrhosis,” senior investigator Dr. Steven Nissen, chief academic officer of the Cleveland Clinic Heart, Vascular and Thoracic Institute, said in a news release.

“However, lifestyle changes alone rarely provide the weight loss and metabolic changes needed to reduce the risk of liver complications in this patient population,” he added.

Obesity and diabetes are the leading cause of MASH, which is the most common form of chronic liver disease in the U.S., researchers said in background notes.

The livers of people who are obese start accumulating fat, triggering a cascade of events ultimately leading to liver scarring, researchers said. An estimated 3 million people in the U.S. have liver scarring related to fatty liver disease.

For this study, researchers aimed to see if the long-term weight loss associated with bariatric surgery could lower the risk of liver damage among people with obesity and fatty liver disease.

A group of 62 patients with both who underwent bariatric surgery were compared to a control group of 106 fatty liver patients who didn’t get weight-loss surgery. Participants were matched for factors like severity of liver disease.

Fifteen years after the study started, patients who got bariatric surgery had lost nearly 27% of their weight, compared with 10% of weight lost among the people who didn’t get surgery.

Nearly 21% of the weight-loss surgery group and 46% of those who didn’t get surgery developed at least one major complication of liver disease, including advanced liver scarring, liver cancer, liver transplantation or death, results show.

Likewise, nearly 16% of those in the surgery group progressed to advanced liver disease, compared with nearly 31% of those who didn’t get surgery.

The study “shows that bariatric surgery is an effective treatment that can influence the trajectory of cirrhosis progression in select patients,” Nissen said.

Similar findings also are possible for the new wave of anti-obesity drugs like Wegovy and Zepbound, given that they provide an average weight loss of 15% to 20%, researchers stated.

More information

The National Institutes of Health has more on fatty liver disease.

SOURCE: Cleveland Clinic, news release, Jan. 27, 2025