Weight-Loss Surgery Bests Medical Weight Management for Obesity-Related Risk Mitigation

WEDNESDAY, Sept. 17, 2025 (HealthDay News) — Bariatric surgery is associated with a significantly lower risk for developing major metabolic comorbidities compared with a medical weight management program for adults with obesity, according to a study published online Sept. 9 in JAMA Network Open.

Amanda L. Bader, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective, multicenter cohort study using data from the Veterans Health Administration Corporate Data Warehouse to assess whether bariatric surgery reduces the risk for developing metabolic comorbidities compared with a medical weight management program for patients with obesity. The analysis included 263,657 veterans who enrolled in a weight management program and 5,813 who underwent bariatric surgery.

The researchers found that at five years, incidence rates per 1,000 person-years were 8.89 for hypertension, 9.67 for hyperlipidemia, 4.29 for type 2 diabetes, 3.99 for obstructive sleep apnea (OSA), and 2.44 for metabolic dysfunction-associated steatotic liver disease (MASLD) in the weight management program group compared with 3.35, 4.85, 1.06, 3.43, and 2.01, respectively, in the bariatric surgery group. Compared with the weight management program, bariatric surgery was associated with a statistically significantly lower risk for incident type 2 diabetes (hazard ratio [HR], 0.21), hypertension (HR, 0.41), hyperlipidemia (HR, 0.49), OSA (HR, 0.43), and MASLD (HR, 0.60). Similar results were seen for a subgroup analysis of only female veterans.

“This finding supports the relevance of bariatric surgery as a durable approach for obesity-related risk mitigation,” the authors write.

Several authors disclosed ties to relevant organizations.

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