Effects of Weight Loss on Non-Alcoholic Fatty Liver Disease (NAFLD) in a United Arab Emirates Based Population: A Comparative Analysis of Bariatric Surgery and Non-Surgical Interventions

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is highly prevalent in the United Arab Emirates, but the comparative effects of bariatric surgery and medical weight loss on NAFLD in this population remain understudied. This study aimed to evaluate the impact of these interventions on NAFLD parameters in severely obese patients. Methods: This prospective study compared 51 patients undergoing bariatric surgery (surgical cohort) with 35 patients undergoing supervised medical weight loss (medical cohort). Anthropometric measurements, comprehensive laboratory tests, and transient elastography (Fibroscan®) were performed at baseline and 12-month follow-up. Intraoperative liver biopsies were conducted for the surgical cohort. Results: At 12-month follow-up, the surgical cohort showed significantly greater improvements in BMI (29.65 ± 5.39 vs 38.42 ± 6.39 kg/m², p<0.001), total weight loss (29.25% vs 1.34%, p<0.001), and liver function markers including ALT (16.55 vs 30.29 U/L, p<0.001). HbA1c levels were lower in the surgical group (5.07% vs 5.57%, p=0.014). Lipid profiles improved more in the surgical cohort. Fibroscan results demonstrated greater reductions in controlled attenuation parameter (321.26 to 234.08 vs 316.88 to 321.00 dB/m, p<0.001) and liver stiffness (5.74 to 4.56 vs 5.84 to 5.36 kPa, p=0.062) in the surgical group, indicating improved liver fat content and fibrosis. Conclusion: Bariatric surgery resulted in superior outcomes for weight loss, metabolic parameters, and improvement in NAFLD markers compared to medical weight loss in this UAE-based population. This suggests its efficacy as an intervention for NAFLD in severely obese patients, though long-term studies are needed to confirm the sustainability of these improvements.