Bariatric Surgery Substantially Lowers Risk of diabetes, Hypertension & Other Obesity-Related Illnesses, New study Finds
Washington, D.C. – Bariatric surgery is associated with a more than 50% reduction in the progress of type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea compared to intensive weight management programs (WMP), according to research published september 8, 2025, in JAMA Network Open. The study, conducted on a cohort of veterans, also demonstrated a 40.4% lower risk of developing metabolic-associated steatolic liver disease (MASLD) following bariatric surgery.Researchers analyzed data from a large group of veterans, comparing outcomes in those who underwent bariatric surgery versus those enrolled in a WMP. Baseline characteristics differed between the groups; the bariatric surgery group was, on average, older (57 years vs 51 years) and had a higher baseline Body Mass Index (BMI) of 44.2 compared to 36.7 in the WMP group. The bariatric surgery group also exhibited a higher prevalence of comorbidities, including type 2 diabetes (37.5% vs 32.0%).
The study followed patients for a median of 112.9 months, revealing significant differences in the incidence of metabolic comorbidities. Unadjusted rates at 5 years showed hypertension occurring in 8.9 per 1000 person-years in the WMP group versus 3.3 in the bariatric surgery group. Similar disparities were observed for hyperlipidemia (9.7 vs 4.9),type 2 diabetes (4.3 vs 1.1), OSA (4.0 vs 3.4), and MASLD (2.4 vs 2.0).
After adjusting for potential confounding factors using propensity score matching, the researchers found that bariatric surgery significantly reduced the hazard of developing each comorbidity. Thes benefits were consistent even within a subcohort of female veterans.”Compared with medical or lifestyle interventions, bariatric surgery offers patients both a higher rate of comorbidity remission and a higher likelihood of de-escalating daily medications,” the study authors wrote. they also noted improvements in mental health and health-related quality of life following bariatric surgery.The study acknowledges limitations including potential misclassification of data, incomplete surgical capture, residual confounding, variability in WMP engagement, and a cohort limited to older, predominantly male veterans.The authors also highlight the emerging role of GLP-1 therapies and the need for further research to understand their interaction with post-bariatric surgery care.
Despite these limitations, the researchers conclude that the observed reduction in metabolic comorbidities contributes to the long-term cardiovascular and oncologic benefits previously associated with bariatric surgery, strengthening the understanding of its mechanistic advantages.
Reference: Bader A, Hsu JY, Altieri MS, et al. bariatric surgery and incident development of obesity-related comorbidities. JAMA Netw Open. 2025; 8 (9): E2530787.DOI: 10.1001/JamanetWorkOPen.2025.30787
