Bariatric Surgery and Incident Development of Obesity-Related Comorbidities
Authors' conclusion
In this cohort study, bariatric surgery was associated with a significantly lower risk of developing major metabolic comorbidities compared with the medical WMP. This finding supports the relevance of bariatric surgery as a durable approach for obesity-related risk mitigation.
Study context
- Population
- Adults ≥18 years with body mass index (BMI) ≥30 and ≥1 of 5 metabolic comorbidities or BMI ≥35, Veterans Health Administration, 2008–2023; 87.1% male, median age 57 years
- Participants
- 269,470 veterans
- Exposure
- Bariatric surgery vs weight management program
- Bariatric surgeryn = 5,813
- Weight management program (WMP)n = 263,657reference
- Outcome
- Incident diagnosis of any of 5 metabolic comorbidities: T2D, hypertension, hyperlipidemia, obstructive sleep apnea (OSA), MASLD
Methodological detailsmulticenter, 128 Veterans Health Administration (VHA) centers
- Multicenter
- 128 VHA centers
Main finding
As reported in the abstract
Incidence rates per 1000 person-years and HRs for incident comorbidities
WMP
8.89 (hypertension); 9.67 (hyperlipidemia); 4.29 (T2D); 3.99 (OSA); 2.44 (MASLD)
per 1000 person-years
Bariatric surgery
3.35 (hypertension); 4.85 (hyperlipidemia); 1.06 (T2D); 3.43 (OSA); 2.01 (MASLD)
per 1000 person-years
Bariatric surgery vs WMPHazard ratio (95% CI)
T2D; 79.2% lower
0.21(0.18–0.26)
Hypertension; 58.8% lower
0.41(0.33–0.51)
Hyperlipidemia; 50.5% lower
0.49(0.42–0.58)
OSA; 56.9% lower
0.43(0.35–0.52)
MASLD; 40.4% lower
0.60(0.49–0.73)
Observational data: associations, not effects.
Further findings
- Results were consistent in a subgroup analysis of only female veterans
Original publication
Bariatric Surgery and Incident Development of Obesity-Related Comorbidities. JAMA Netw Open. Published 2 September 2025. doi:10.
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