Bariatric Surgery Reverses Liver Fibrosis in Some Patients with Nonalcoholic Steatohepatitis

Weight loss is the primary intervention for managing patients who are overweight and have nonalcoholic fatty liver disease or its progressive and potentially lethal form, nonalcoholic steatohepatitis (NASH). But lifestyle interventions alone rarely achieve enough weight loss for resolution of NASH.

Italian investigators randomized 300 patients with histologically confirmed NASH and obesity (with or without type 2 diabetes) to Roux-en-Y gastric bypass, sleeve gastrectomy, or lifestyle modification with best medical care (including pioglitazone, liraglutide, and other antidiabetes medications, as needed). At 1 year, liver biopsy showed that patients who received gastric bypass or sleeve gastrectomy were significantly more likely to achieve his…