Ever since my Mom passed away suddenly after being diagnosed with late-stage NASH, I’ve been following the efforts of the medical community and many bio-pharma companies to develop effective treatments for the disease. Mostly, I’ve followed the efforts to develop medicine that can slow or reverse the effects of NASH, as there is a lot of attention being paid to this and some recent successful trials.
I recently attended an event with a distinguished panel of liver experts and one of the discussion points that surprised me was how effective weight-loss surgery is at treating NASH. I shouldn’t have been surprised, I suppose, because I already knew that losing a small amount of weight can lead to big improvements in NASH patients. Surgery just seemed “extreme” to me, but in fact it is by far the most effective way to achieve sustained weight loss, and has even been called one of the most effective interventions in all of health care.
“Bariatric surgery is probably the most effective intervention we have in health care,” – Laurie K. Twells, Memorial University of Newfoundland.
One of the most challenging things for people attempting to reduce their weight permanently is keeping the weight off. And the data that we have is incredibly daunting, suggesting that only FIVE PERCENT of people attempting permanent, long-term weight loss are successful over time. And more and more research is confirming what doctors have known for a very long time; the struggles with weight loss are mostly biological and not a matter of will. In other words, even the people fully committed to losing weight are facing an uphill battle with their own bodies natural inclination to maintain weight.
Some of the latest research is examining the effectiveness of weight-loss surgery with some surprising findings. Researches have found that it may be the drastic change in the body’s microbiota, rather than simply the reduction in size of the stomach, that is responsible for the ability of the patients to loss weight quickly and effectively. This suggests that future treatments for weight-loss could focus on changing the microbiota directly rather than far more invasive surgery.
There are unfortunately a lot of stigmas surrounding obesity, and specifically with weight-loss surgery. People still see it as the “easy way out”, and associate it with laziness, competence, and responsibility for weight loss. However, in the eyes of the medical community, it is viewed as the best available treatment for obesity, and could represent the best chance that patients with severe NASH have for avoiding permanent liver disease.