Health Care

Reversing Fatty Liver with Bariatric Surgery

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If you’re living with a condition known as fatty liver, it may be time to consider bariatric surgery as an option for losing weight and reducing fatty deposits from the liver.

Dangers of Living With Fatty Liver

“At least 75 million Americans have fatty liver, and about 5% of people with fatty liver will progress to cirrhosis and may require a liver transplant,” says Dennis Smith, MD, FACS, FASMBS, AdventHealth Bariatric Surgeon. “Once inflammation is set in the liver from chronic fat deposition, 20% of those patients may progress to cirrhosis.”

The first medical treatment for fatty liver will include a diet, lifestyle modification, and vitamin E supplements. However, in patients with obesity, diet and lifestyle modification are effective in just a small number of patients. Dr. Smith feels that bariatric surgery offers durable and sustainable weight loss and effective reversal of fatty liver, in addition to improving other health conditions.

Bariatric surgery is also often referred to as weight loss surgery, but that’s not the only purpose of bariatric surgery, explains Dr. Smith.

“The more important benefits of bariatric surgery are the improvements of general health and quality of life,” he says. Specifically, those with the following conditions can see dramatic improvement after weight loss, to the point of not requiring medications or treatments:

  • Degenerative joint disease
  • Diabetes
  • Fatty liver
  • Heartburn
  • Hyperlipidemia
  • Hypertension
  • Sleep apnea

Common Types of Bariatric Surgery

The most common bariatric operations are the Roux-en-Y (RNY) gastric bypass and sleeve gastrectomy. These procedures are performed laparoscopically and robotically through small incisions, reducing pain and minimizing recovery after surgery.

With gastric bypass surgery, a small pouch is created from the top portion of the stomach, which is then connected directly to the small intestine. Food is swallowed, goes to the pouch, and then goes directly into the small intestine, bypassing the rest of the stomach (that’s why this is called gastric bypass!). This operation reduces the amount of food that can be ingested and profoundly impacts how the body metabolizes foods and carbohydrates.

The stomach is divided into two sections with a sleeve gastrectomy procedure, and the larger one is removed. The stomach pouch that remains is the shape and size of a small banana and can no longer store large portions of food. The effects of sleeve gastrectomy on metabolism are not nearly as powerful as with the gastric bypass.

The duodenal switch procedure is the most powerful operation regarding weight loss, effectiveness against medical problems, and reversal of fatty liver. It involves both a sleeve gastrectomy and an intestinal bypass to result in more dramatic results but also has more side effects.

Recovery Process

Dr. Smith states, “These operations have progressed to the point where there is very little pain and only a short hospital stay.”

We utilize special medications and strategies at AdventHealth Weight Loss and Bariatric Surgery to minimize pain and nausea and hasten recovery. During the recovery time, Dr. Smith says it’s important for the patient to “adjust to new eating habits and focus on their well-being.”

Some people may be concerned about bariatric surgery's risks or side effects. Dr. Smith explains that these operations are typically associated with a very low risk of complications. According to the American Society of Metabolic and Bariatric Surgery, the risk of death following this surgery averages less than 0.1%, which Dr. Smith says is “considerably less than most other operations, including gallbladder and hip replacement surgery.”

Who Is a Candidate for Bariatric Surgery?

If you have a body mass index (BMI) greater than 40 kg/m2 (approximately 100 pounds overweight), you may qualify for bariatric surgery on BMI alone. Patients with a BMI of 35-39 kg/m2 and a major medical condition such as diabetes, hypertension, or sleep apnea may also be candidates for surgery.

Fatty liver is associated with the accumulation of fat in the liver, a condition known as fatty liver. Fatty deposition not only enlarges the size of the liver but also may contribute to diabetes by increasing insulin resistance in the liver itself.

As patients lose weight after bariatric surgery, fatty deposits in the liver are reduced, which is associated with improving insulin sensitivity and correcting diabetes.

More importantly, Dr. Smith explains, “fat deposition in the liver for a long time induces chronic inflammation and fibrosis, which can lead to cirrhosis. Patients who develop cirrhosis have a short life expectancy because of worsening liver function and liver failure.”

Bariatric surgery effectively reduces fatty liver deposits and inflammation in the liver, says Dr. Smith.

AdventHealth Weight Loss and Bariatric Surgery

Our team is here to help you live your best and healthiest life. For more information on surgical procedures performed at AdventHealth Weight Loss and Bariatric Surgery, click here.

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