JAMA Netw Open

Bariatric surgery may reduce risk of multiple metabolic comorbidities in patients with obesity

September 11, 2025

Study details: This retrospective cohort study analyzed 269,470 U.S. veterans with obesity, including 5,813 who underwent bariatric surgery and 263,657 enrolled in a weight management program (WMP). The cohort was predominantly male (87.1%) with a median age of 57 years and a median follow-up of 113 months. Researchers compared incidence rates of obesity-related comorbidities over 5 years.

Results: At 5 years, bariatric surgery was associated with significantly lower incidence rates per 1000 person-years for the following compared with the WMP group:

• Hypertension: 3.35 vs. 8.89
• Hyperlipidemia: 4.85 vs. 9.67
• T2DM: 1.06 vs. 4.29
• Obstructive sleep apnea (OSA): 3.43 vs. 3.99
• Metabolic dysfunction-associated steatotic liver disease (MASLD): 2.01 vs. 2.44

Hazard ratios showed substantial risk reductions:

• 79.2% for T2DM; 95% confidence interval (CI), 0.18-0.26
• 58.8% for hypertension; 95% CI, 0.33-0.51
• 50.5% for hyperlipidemia; 95% CI, 0.42-0.58
• 56.9% for OSA; 95% CI, 0.35-0.52
• 40.4% for MASLD; CI, 0.49-0.73

Findings were consistent in female veterans.

Clinical impact: Bariatric surgery is associated with durable protection against multiple obesity-related conditions, reinforcing its role as a proactive strategy for long-term metabolic disease prevention in high-risk patients.

Source:

Bader AL, et al. (2025, September 2). JAMA Netw Open. Bariatric Surgery and Incident Development of Obesity-Related Comorbidities. https://pubmed.ncbi.nlm.nih.gov/40924423/