Weight Loss Surgery May Reduce Risk of Severe Liver Disease, New Study Finds

One in four American adults suffers from fatty liver disease caused by obesity, without drinking, and there is no medical treatment for ...


One in four American adults suffers from fatty liver disease caused by obesity, without drinking, and there is no medical treatment for it. Doctors say the only way to control it is to lose weight and eat healthier.

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

Only five of 650 patients who underwent weight loss surgery later developed any of these serious liver findings, compared with 40 of the 508 patients who did not undergo the procedure.

Patients who had weight loss surgery also had a significantly lower risk of cardiovascular disease, a finding that is consistent with previous research. They were 70% less likely to have a heart event, stroke or heart failure, or die from heart disease, according to the study published Thursday in JAMA.

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

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

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

The results were remarkable, said Dr. Steven Nissen, academic director of the Heart and Vascular Institute at the Cleveland Clinic and lead author of the study.

The outcome for post-surgical disease “was the lowest I have seen in 30 years of studies, an 88 percent reduction in progression to advanced liver disease,” he said.

The 12-year observational study looking at the Cleveland Clinic cases did not establish a causal link with a decreased risk of serious liver or heart disease from weight loss procedures, but the results add up growing evidence that weight loss surgery can provide health benefits beyond weight loss. . About 100 million American adults are dangerously obese; approximately 250,000 undergo bariatric operations each year.

However, the surgery carries serious risks. 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 the operation.

The most common procedure performed is called a sleeve gastrectomy. Only a fifth of the patients studied in this report have had this procedure. The vast majority have undergone Roux-en-Y gastric bypass surgery.

Over 40 percent of American adults struggle with obesity. About 75 percent have nonalcoholic fatty liver disease, which is often a silent disease with no obvious symptoms. But one in four or five people will develop an aggressive form of the disease called nonalcoholic steatohepatitis, or NASH, which causes fibrosis of the liver, and one in five people will develop cirrhosis, or scarring of the liver, for which the only cure is a liver transplant.

There are no approved drugs or therapies available for nonalcoholic fatty liver disease. Doctors generally advise patients to lose weight and eat a healthier diet to reduce fat, inflammation, and fibrosis in the liver, a vital organ that turns food and drink into nutrients and filters out harmful substances. some blood.

Obese patients who have weight loss surgery typically lose up to 25 percent of their body weight, much more than patients who diet to lose weight. After surgery, they often need less medication to control conditions like type 2 diabetes, high blood pressure, and high cholesterol.

The new study, however, is not definitive. This was a retrospective observational study that compared the long-term outcomes of 650 patients who had bariatric surgery with 508 closely matched patients who had not had surgery. As such, this was not a randomized controlled trial of the type considered the gold standard in medicine, which randomly assigns patients with similar characteristics to an intervention arm or a placebo.

Several of the article’s 16 authors consult or receive research funding from companies that manufacture devices used in weight loss surgery. Dr Aminian and Dr Nissen both receive funding from Medtronic, the world’s largest medical device company, and Dr Nissen also receive funding from Ethicon, a manufacturer of medical devices and surgical instruments. However, they did not receive external funding for this study.

One concern in studies like these is that patients who choose weight loss surgery may be inherently different from those who don’t. They can be more motivated; they have health coverage or the means to cover acts; and they’re healthy enough that surgeons won’t reject them.

In this case, however, said Dr Nissen, the benefit was so stark that “even if it’s wrong by a factor of two, it still means the risk is drastically reduced.”

The study looked at the Cleveland Clinic cases of 1,158 obese patients whose liver biopsies from 2004 to 2016 showed they had advanced non-alcoholic fatty liver disease with fibrosis. Women made up over 60 percent of patients; the average age was just under 50; and the median body mass index was 44, which is considered dangerously overweight. Heart disease was also reduced after weight loss surgery, as previous studies have shown: about 8.5% of those who had weight loss surgery had a cardiac event, compared to 15.7% of those who have not had surgery.

“Fatty liver disease is really the single most important disease that most Americans know next to nothing about,” Dr. Nissen said. “It is now a more important cause of liver failure than alcohol. And with the obesity epidemic, this disease is really increasing at a frightening rate. “

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Newsrust - US Top News: Weight Loss Surgery May Reduce Risk of Severe Liver Disease, New Study Finds
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