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Bariatric–metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trial

Verrastro O, Panunzi S, Castagneto-Gissey L, De Gaetano A, Lembo E, Capristo E et al.

Lancet 2023; 401: 1786-1797.

A total of 288 patients were randomly allocated to best medical therapy or one of two bariatric procedures. Stereohepatitis resolved in 70  per cent of patients who had either Roux-en-Y gastric bypass or sleeve gastrectomy compared to 19 per cent in the best medical treatment group; P<0.0001.

Comment: This study shows convincing evidence that non-alcoholic fatty liver can be reversed by bariatric surgery. Is that alone a reasonable indication?

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