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Another Health Benefit of Bariatric Surgery

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It can help reverse nonalcohol-related fatty liver disease

Posted by Rohit Soans, MD

As a bariatric surgeon, I've spent many years educating patients and their families about the positive health effects of weight-loss surgery. And recently, I've started discussing a new benefit: Better management or reversal of nonalcohol-related fatty liver disease.

Nonalcohol-related fatty liver disease, or NAFLD, is a serious condition that can occur as a result of excess weight. NAFLD affects up to 75% of people who are overweight and more than 90% of those who are severely obese.

We don't currently have any medicines to treat NAFLD. But bariatric surgery is showing promising results as a tool that can help reduce the risks associated with the condition — and help my patients live longer, healthier lives.

If you or a loved one have NAFLD or are considering weight-loss surgery, here's what you should know about this treatment option.

The dangers of NAFLD

NAFLD is a condition marked by excess fat in the liver. Unlike alcohol-related liver disease, NAFLD is not tied to drinking. Instead, a person may develop the condition if they have higher-than-healthy levels of body fat, along with conditions that may be weight-related, such as diabetes or high cholesterol.

NAFLD doesn't always cause noticeable symptoms, but it can cause the liver to become enlarged and, in some cases, painful. Fat buildup may also result in inflammation of the liver, which can lead to scarring and permanent damage, including cirrhosis. Over time, this scarring and damage increases the risk for liver failure or the need for a liver transplant.

NAFLD is associated with other serious health problems, too. People who have it are more likely to have heart disease or metabolic syndrome, which is a group of conditions that can increase your risk of having a stroke or being diagnosed with diabetes, for example.

Treating NAFLD with bariatric surgery

Since the Food and Drug Administration has not approved any medications to treat NAFLD, physicians have traditionally recommended that patients manage the condition by losing weight. The loss of body fat can reduce fat in the liver, which can lower inflammation and stop, or even reverse, liver scarring.

For some patients, successful weight loss can be achieved with healthy food choices, limiting portions, and being more active. But these strategies aren't always enough to help patients reach a healthier weight and get their NAFLD under control. In those cases, I may recommend weight-loss surgery.

I explain that a growing body of evidence shows that bariatric surgery can be an effective treatment option for NAFLD. The procedure can help patients lose up to 25% of their body weight — a significant loss that has been found to improve liver health and function.

Who is eligible for bariatric surgery?

Many adults with significant excess weight are candidates for weight-loss surgery. This includes those who:

  • Have not been able to lose weight and keep it off with diet and exercise
  • Have a body mass index (BMI) greater than 40 (calculate yours here)
  • Have a BMI greater than 35 and at least two weight-related health conditions, such as NAFLD, type 2 diabetes, high blood pressure, sleep apnea, osteoarthritis, or heart disease

Aside from meeting the criteria above, I emphasize to my patients the importance of being mentally prepared for weight-loss surgery and its after-effects. The surgery is generally considered safe, but like with all major operations, it involves some risks, which your doctor will discuss with you.

I point out, too, that bariatric surgery doesn’t cure everything by itself. Patients have the best shot at long-term success of losing weight and keeping it off when they commit to making healthy lifestyle changes, such as choosing healthier foods, eating smaller portions, and being more active. It’s a requirement to start these new habits before surgery to ensure a successful outcome after surgery.

With all that in mind, a patient undergoing bariatric surgery will have the support of an entire team that is focused on their success. Having a team of experts on their side — including nutritionists, and mental health professionals — helps patients undergoing bariatric surgery get the support they need to reach a healthier weight and stay at their weight goal for years to come.

Learn more about weight-loss surgery

Are you or a loved one considering bariatric surgery? Find out more about Temple 's weight-loss surgery program. Register for a free, virtual bariatric surgery seminar today.

Helpful Resources

Looking for more information?

Rohit Soans, MD

Rohit Soans, MD, is Medical Director of Bariatric Surgery at Temple University Hospital. He is also Assistant Professor of Surgery at Lewis Katz School of Medicine at Temple University. His clinical interests include metabolic and bariatric surgery, minimally invasive and robotic general surgery, gastrointestinal disorders, and outcomes following bariatric surgery.

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