Effectiveness of bariatric surgery can be gleaned from genes

A large-scale study involving Estonian scientists suggests that the benefits of weight-loss surgery may be partly determined by genetics. The discovery could help improve the effectiveness of obesity treatments in the future.
It is known that a large portion of people — by some estimates, up to two-thirds — want to lose weight. On average, individuals can reduce their weight by about 5 percent through behavioral changes alone. In addition to behavioral approaches, there are also weight-loss aids available that can help people lose weight more effectively. These include drugs like semaglutides, such as Ozempic. However, such medications work better for some people than for others.
Uku Vainik, a professor of behavioral genetics at the University of Tartu, collaborated with researchers from several other countries to investigate whether the effectiveness of semaglutides and weight-loss surgery can be predicted based on genetics. The study was conducted using data from more than 10,000 individuals from around the world.
"Broadly speaking, we found that even 10,000 people is too small a sample to detect the effects of semaglutide. We tested both individual genetic markers and polygenic scores, but found nothing meaningful in relation to semaglutide," the professor noted.
In contrast, the researchers did find a genetic link when it came to bariatric surgery, where individuals tend to lose more weight at once. The outcomes vary more significantly from person to person. Specifically, surgery appears to be less effective for individuals who have a genetic predisposition to obesity. This means they require more support after the procedure to prevent regaining weight quickly.
Vainik emphasized that surgery is not a magic solution and must be followed by lifestyle changes, particularly dietary ones. To avoid relapse, individuals — especially those with a strong genetic tendency toward obesity — definitely need support.
"In the future, people should undergo a screening process for weight-loss challenges, perhaps through genetic testing or a questionnaire. This would help identify who needs more attention and support during the procedure. Ultimately, the project's goal is to make the weight-loss journey as effective as possible for those who choose to pursue it," Vainik said.
However, if weight-loss surgery proves ineffective, patients can instead switch to medication. Vainik acknowledged that the medication must be taken continuously, but if done consistently, the rate of relapse is slower.
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Editor: Marcus Turovski