A new study from Rutgers University in collaboration with Ohio State University found that people with obesity and non-alcoholic fatty liver disease (NAFLD) experienced fewer cardiovascular events after undergoing bariatric weight loss surgery.

Published in JAMA Network Open, the study found that patients with obesity who underwent bariatric surgery were about 50% less likely to develop extreme cardiovascular events, such as strokes, heart attacks or angina.

In the United States, heart disease is the leading cause of death for men and women across all racial and ethnic groups. According to the Centers for Disease Control and Prevention, about 697,000 individuals died of heart disease in 2020.

“The findings provide evidence in support of bariatric surgery as an effective therapeutic tool to lower elevated risk of cardiovascular disease for select individuals with obesity and NAFLD,” said Vinod Rustgi, clinical director of hepatology and director of the Center for Liver Diseases and Liver Masses at Rutgers Robert Wood Johnson Medical School, in a Rutgers news release. “These finding are tremendously impactful for many reasons.”


NAFLD and its more sever form, non-alcoholic steatohepatitis (NASH), occur when too much fat is stored in liver cells, causing inflammation. Over time, this can lead to fibrosis, cirrhosis and liver cancer. In many cases, liver fat accumulation is associated with obesity and diabetes. There are no approved medications for NAFLD and NASH, so management generally relies on lifestyle changes such as weight loss and exercise.


For this study, researchers analyzed 86,964 adults between 18 and 64 years old who had obesity and NAFLD. Of those patients, 35% underwent bariatric surgery. These individuals experienced a 49% percent decrease in the risk for major cardiovascular events and were less likely to experience arterial blood clots, angina or other health issues caused by a buildup of fats or cholesterol in the arteries.


The researchers say this study is the first of its kind to observe the association between bariatric surgery and the reduction of cardiovascular disease at this level of detail.

“Although bariatric surgery is a more aggressive approach than lifestyle modifications, it may be associated with other benefits, such as improved quality of life and decreased long-term health care burden,” Rustgi said.