Risk of liver disease with weight loss surgery: Study

bariatric surgery

Researchers find that there is a risk of liver disease after one gets a bariatric surgery for weight loss, even though they did not find a direct link. 

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Obese patients who undergo a weight loss procedure known as bariatric surgery may live longer, healthier lives, but they have a high risk of getting liver complications, a new study has shown.

Bariatric surgery is a series of procedures done on people trying to lose weight when both a change in diet and physical exercises fail to yield any results. Its main purpose is to tweak the digestive system and goes for at least Sh350,000 in the country.

“Some types of weight loss operations make your stomach smaller, limiting how much you can eat and drink at one time, so you feel full sooner. Other weight loss operations change your small intestine – the part of your digestive system that absorbs energy and nutrients from foods and beverages,” the National Institute of Diabetes and Digestive Kidney Diseases explains.

For about 40 years, the researchers, who published their findings in the Obesity journal, followed two groups of participants – those who had bariatric surgery and those who opted not to.

They found out that those who had the surgery were less likely to die from heart disease, diabetes, or cancer, which are common among obese patients. There was a 16 per cent lower risk of dying in the surgery group compared to the non-surgery one.

Life expectancy

“This important study adds to the mounting evidence that bariatric surgery not only improves quality of life for patients, but will also increase their life expectancy. This work will hopefully improve patients’ access to this effective treatment for obesity, which is still limited to only one per cent of qualified patients,” says Dr Jihad Kudsi, a bariatric surgeon who was not part of the study.

However, surgery participants were more likely to die from chronic liver disease compared to the non-surgery group. But the researchers were not able to establish a direct relationship between the surgery and the likelihood of getting liver complications.

“Alcohol use and clinical liver disease details were not available in our study. One possibility that would explain these discrepant results is that the increased mortality after bariatric surgery in our study was derived from those with possible liver cirrhosis at baseline, and, once cirrhosis has occurred, resolution is limited after surgery,” explain the researchers.

The new finding sparks another debate that was previously associated with bariatric surgery after some researchers suggested that there were some negative outcomes post-operation.

“Serious concern, however, continues to be exhibited regarding increased mortality following bariatric surgery in relation to suicide, accidents and cirrhosis of the liver. This study showed that the primary group associated with this untoward mortality outcome is patients choosing to have bariatric surgery between ages 18 and 34 years, suggesting that this age group may require more aggressive pre-surgical psychological screening and post-surgery follow-up,” the researchers explain.

“Consistent with previous findings, deaths related to external causes such as suicide and accidents were significantly greater (2.35 times) among bariatric surgery patients compared with matched non-surgical participants,” states the study.

Other studies, such as the one published in the Jama Network journal, backs the quality of life associated with bariatric surgery.

Weight loss

“Bariatric surgery provides substantial and sustained effects on weight loss and ameliorates obesity-attributable comorbidities in the majority of bariatric patients, although risks of complication, reoperation and death exist,” says the study.

A review published in the British Journal of Surgery gave a caveat for patients who opt for the surgery, showing that there are some medical and psychological complications after the surgery.

“It should also be acknowledged that a considerable proportion of operated patients experience side-effects, which often manifest many years after the procedure, including various gastrointestinal disorders and need for endoscopic or surgical reinterventions,” it explains.

“Despite major health benefits, bariatric surgery is associated with risks of several late-occurring and serious medical conditions that may be difficult to treat, often requiring lifestyle changes, medication and additional surgery. Understanding these risks is important for healthcare providers and patients,” states the review.

According to the University of Pittsburg Medical Centre, other side effects of bariatric surgery include acid reflux, chronic nausea and vomiting, inability to eat certain foods and malnutrition.