Bariatric Surgery Outperforms Medical Management in Reducing Obesity-Related Health Risks

A recent study highlights that bariatric surgery significantly lowers the risk of developing major metabolic conditions compared to traditional medical weight management programs in adults with obesity. Published online on September 9, 2025, in JAMA Network Open, this research provides compelling evidence supporting surgical intervention as a more effective strategy for long-term risk reduction.

The study, led by Dr. Amanda L. Bader from the University of Pennsylvania, analyzed data from the Veterans Health Administration. It involved nearly 269,470 veterans, with 263,657 participating in weight management programs and 5,813 undergoing bariatric surgery. Over a five-year follow-up period, researchers found substantial differences in the incidence rates of several metabolic conditions between the two groups.

Patients who received bariatric surgery had lower incidence rates of hypertension, hyperlipidemia, type 2 diabetes, obstructive sleep apnea, and metabolic dysfunction-associated steatotic liver disease (MASLD). Specifically, the rates per 1,000 person-years were consistently lower in the surgical group: 3.35 versus 8.89 for hypertension, 4.85 versus 9.67 for hyperlipidemia, 1.06 versus 4.29 for type 2 diabetes, 3.43 versus 3.99 for OSA, and 2.01 versus 2.44 for MASLD.

Statistical analysis revealed that bariatric surgery was associated with a significantly reduced risk of developing these conditions. For example, the hazard ratio for incident type 2 diabetes was 0.21, indicating a 79% risk reduction, while for hypertension, it was 0.41. Similar protective effects were observed for hyperlipidemia, OSA, and MASLD. Subgroup analysis of female veterans also showed consistent results.

This evidence underscores the importance of considering bariatric surgery not only for weight loss but as a durable intervention to mitigate serious health risks associated with obesity. The findings suggest that surgical options should be strongly considered in comprehensive obesity management, especially when aiming for long-term health benefits.

For more details, the full study is available in JAMA Network Open (2025). Source: https://medicalxpress.com/news/2025-09-weight-loss-surgery-bests-medical.html