Impact of Per- and Polyfluoroalkyl Substances on Weight Regain Post-Bariatric Surgery in Adolescents: A New Study Insights
By Brittney O. Baumert, Elizabeth Costello, Zhenjiang Li, Justin R. Ryder, Thomas Inge, Todd Jenkins, Stephanie Sisley, Stavra A. Xanthakos, Douglas I. Walker, Nikos Stratakis, Damaskini Valvi, Scott M. Bartell, Angela L. Slitt, Rohit Kohli, Sarah Rock, Michele A. La Merrill, Sandrah P. Eckel, Max T. Aung, Rob McConnell, David V. Conti, and Lida Chatzi
Obesity (Silver Spring)
August 14, 2025
DOI: 10.1002/oby.70009
The challenge of weight regain following bariatric surgery, particularly among adolescents, has gained increasing attention in recent years. A new study emphasizes the role of environmental factors, specifically the exposure to per- and polyfluoroalkyl substances (PFAS), which are persistent chemicals that have been associated with metabolic dysfunction. This study investigates the potential impact of PFAS exposure on long-term weight trajectories in adolescents who have undergone bariatric surgery.
Conducted under the auspices of the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort, this research involved a comprehensive analysis of 186 adolescents (average age: 17.1 years, 76.3% female, 72.0% White) who underwent surgical interventions between 2007 and 2012. The study employed rigorous methods for data collection, including anthropometric measurements taken at baseline and at multiple intervals post-surgery (6, 12, 36, and 60 months). The researchers quantified presurgical plasma concentrations of seven PFAS compounds using advanced liquid chromatography-tandem mass spectrometry.
The findings revealed that heightened levels of specific PFAS compounds—including perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS), and perfluoroheptanesulfonic acid (PFHpS)—were significantly correlated with adverse changes in body mass index (BMI), percentage of weight loss, and waist circumference over a five-year period post-surgery. Notably, at PFOS concentrations between 1.45 to 2.94 log ng/mL, the annual rate of BMI regain escalated from 1.34 to 1.84 kg/m (p = 0.0497). The analysis also entertained mixture effects, with data supporting that certain sulfonic acids displayed the strongest negative associations with weight management outcomes.
The implications of these findings are profound; PFAS exposure appears to undermine the metabolic advantages typically gained through bariatric surgery, leading to significant concerns for long-term health in adolescents. This underscores the necessity for comprehensive strategies that address environmental exposures in clinical settings, particularly for vulnerable populations such as adolescents undergoing weight-loss interventions.
As this study highlights, understanding the interplay between environmental toxins and health outcomes remains critical. The clinical community may need to reconsider approaches to managing obesity and related disorders, potentially integrating environmental health considerations into patient care protocols and public health policies.
ClinicalTrials.gov identifier for the original research: NCT00474318.
For further reading, see the article here.