Obesity is a major risk factor for liver disease, and according to a new study published in the Journal of Hepatology, there may be a benefit to bariatric surgery, if you are obese.
A lack of enough elasticity in the stomach is the cause of weight gain in the first place. It means your body cannot use its own fat to fuel the energy-dense foods you eat. As such, bariatric surgery can help with the problem. This study may help to support the benefits of surgery.
Bariatric surgery decreases the size of the stomach to help regulate food intake and put more energy back into the body.
For the new study, researchers studied 3,131 overweight or obese adults with severe liver disease. The patients were followed for 12 years.
During this time, patients were regularly assessed by their primary care physicians and liver disease specialists for metabolic (heart, blood, liver, cancer) and metabolic complications, such as diabetes, hypertension, and liver cancer.
Changes in risk factors
The researchers compared these assessments with patients’ bariatric surgery outcomes.
They found that the bariatric surgery was associated with lower liver disease risks, whereas the complications were not. However, the risks were not much lower when compared with adults without bariatric surgery.
The researchers found that 26.7 percent of patients who underwent bariatric surgery had complications; this figure was almost identical to the rate among adults who did not have surgery.
The researchers also found that the median age of these 30 patients who underwent bariatric surgery was around 67.
One of the key causes of the complications was muscle wasting. As a result, many of the patients reported a relapse of liver disease in just 12 months after having the surgery.
In particular, the study found that 5 out of these 30 patients developed severe liver disease, with 85 percent of these cases occurring in patients with muscle wasting.
What the researchers found was that there was some benefit in the reduction of high triglycerides, blood pressure, and LDL cholesterol, but the reduction in LDL cholesterol was tiny.
In fact, this is likely to be because low LDL cholesterol is associated with death from heart disease, heart attacks, or strokes in adults.
Excess fat around the liver is also likely to make blood clots more likely. This is because fatty liver disease causes some of the body’s cells to fold themselves into very large structures that clog our blood vessels.
Furthermore, very small decreases in blood pressure also seem to be the main advantage of bariatric surgery.
Liver diseases can lead to other complications, such as cancers. Cancer occurs in around 30 percent of adults with chronic liver disease, but for one in five of these cases, the cancer remains untreated.
There are other complications with liver diseases such as stomach ulcers, non-alcoholic fatty liver disease, and hepatitis. These can also become worse, and multiple complications from chronic liver disease have been linked to death.
For example, one of the study’s authors, Thomas Harrington, PhD, Ph.D., research associate at the Centre for Bariatric and Metabolic Research in the MRC Centre for Liver Disease Research in the School of Clinical Sciences at Queen Mary University of London, who co-led the study, states:
“The obesity epidemic has had a huge impact on the prevalence of liver disease in England. Of the 156,874 adults who were assessed for liver disease during the study, 37,573 individuals were found to have a serious illness or cirrhosis. Previous studies have estimated that the prevalence of liver disease is 10 times higher than it was in the late 1970s.”
“There is therefore compelling evidence that if we can reduce the risk of hepatitis C and, in particular, diabetes by actively managing weight and liver function, we can help to significantly improve the lives of this population. Our study suggests that advanced and severe liver disease in this population is substantially decreased, while the benefits of any other treatments seem to be modest.”
The researchers hope that future studies with a longer follow-up period will be able to better understand how bariatric surgery affects the severity of other liver diseases.