The role of bariatric surgery in the management of nonalcoholic fatty liver disease and metabolic syndrome
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. NAFLD is strongly associated with obesity and metabolic syndrome (MetS). Current treatment of NAFLD is based on weight reduction. Bariatric surgery is the most effective treatment for morbid obesity and its associated metabolic comorbidities. There is evidence indicating that bariatric surgery improves histological and biochemical parameters of NAFLD, but currently is not considered a treatment option for NAFLD. The aim of this work is to review the evidence for the effects of bariatric surgery on NAFLD and the MetS. We found that insulin resistance, alterations in glucose metabolism, hypertension, plasma lipids, transaminases, liver steatosis, steatohepatitis and fibrosis improve after bariatric surgery. Weight loss and improvement of NAFLD are greater after RYGB than after other interventions. These findings were obtained from retrospective or cohort studies. There are no studies designed to evaluate liver-specific mortality, liver transplantation, or quality of life. Patients with indications for bariatric surgery will benefit from the improvements in the MetS and NAFLD.
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The proportion achieving remission of MASLD induced by dietary weight loss of 10-15 kg is similar to that seen with very large weight losses post-bariatric surgery.
“The proportion achieving remission of MASLD induced by dietary weight loss of 10–15 kg is similar to that seen with very large weight losses post‐bariatric surgery.”
Remission of diabetes is around 83% at 2 years after bariatric surgery with weight losses up to 35%.
“with remission of diabetes of around 83% at 2 years after bariatric surgery with weight losses up to 35%.”
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Mechanick, J. I., Apovian, C., Brethauer, S., Garvey, W. T., Joffe, A. M., Kim, J., Kushner, R. F., Lindquist, R., Pessah-Pollack, R., Seger, J., et al. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.10.025 · Cited by 608 · see citing works
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Seghieri, M., Christensen, A. S., Andersen, A., Solini, A., Knop, F. K., & Vilsbøll, T. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00649 · Cited by 92 · see citing works
de Brito e Silva, M. B., Tustumi, F., de Miranda Neto, A. A., Dantas, A. C. B., Santo, M. A., & Cecconello, I. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05412-y · Cited by 66 · see citing works
Zhyzhneuskaya, S. V., Al‐Mrabeh, A. H., Peters, C., Barnes, A. C., Hollingsworth, K. G., Welsh, P., Sattar, N., Lean, M. E. J., & Taylor, R. (2025) · Diabetic Medicine · doi:10.1111/dme.15462 · Cited by 6 · see citing works
- Authors
- Aguilar-Olivos, N. E., Almeda-Valdes, P., Aguilar-Salinas, C. A., Uribe, M., & Méndez-Sánchez, N.
- Affiliations
- Hospital Médica Sur (MX)
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX)
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 65
- Issue
- 8
- Pages
- 1196-1207
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W1655941883
- Cited by
- 100
- References
- 105
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 11 · 2022: 9 · 2021: 10 · 2020: 11 · 2019: 14 · 2018: 7 · 2017: 16 · 2016: 13
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medica Sur Clinic & Foundation
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- bariatric surgery, non-alcoholic fatty liver disease, metabolic syndrome, morbid obesity, Roux-en-Y gastric bypass, insulin resistance, glucose metabolism, hypertension, plasma lipids, hepatic steatosis, steatohepatitis, liver fibrosis, weight loss
- MeSH terms
- Humans, Insulin Resistance, Lipids, Liver, Obesity, Morbid, Treatment Outcome, Metabolic Syndrome, Bariatric Surgery, Non-alcoholic Fatty Liver Disease
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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