PFAS exposure May Undo Metabolic Benefits of Weight Loss surgery in Teens
Exposure to common industrial chemicals known as PFAS could considerably diminish the long-term metabolic benefits of bariatric surgery in adolescents, according to a groundbreaking new study from the University of Southern California.
A new study published in Environmental Endocrinology reveals that teenagers with higher levels of per- and polyfluoroalkyl substances (PFAS) in their blood before undergoing weight loss surgery experienced smaller improvements in blood sugar control over five years. These differences were substantial enough to suggest the surgery’s metabolic advantages could be eroded within a decade, raising concerns about the impact of environmental toxins on patient outcomes.
The pervasive Threat of PFAS
PFAS are a class of over 10,000 industrial chemicals used in countless consumer products – from non-stick cookware to firefighting foam – and are notorious for accumulating in the human body over time. Nearly all U.S. adults have detectable levels of these chemicals in their blood,and they have been linked to a range of adverse health effects,including kidney and liver problems,certain cancers,and increasingly,metabolic disorders like type 2 diabetes.
The USC research, spearheaded by scientists at the Keck School of Medicine’s Southern california Superfund Research and Training Program for PFAS Assessment, remediation and Prevention (ShARP) Center, builds on a growing body of evidence highlighting the potential role of PFAS in disrupting metabolic health. The ShARP Center is dedicated to identifying the health effects of hazardous chemicals and developing strategies for prevention and policy change.
Study Details and Key findings
Researchers analyzed data from the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS), a study tracking the outcomes of 186 adolescents (aged 19 or younger) who underwent bariatric surgery between 2014 and 2019. The study found that for every one-unit increase in PFAS levels in the blood, adolescents experienced a corresponding decrease in improvements in glucose homeostasis – the body’s ability to regulate blood sugar – over the five-year follow-up period.
“Our findings show that it’s vital for environmental epidemiologists and physicians to collaborate,” stated a senior researcher involved in the study. “Targeted precision medicine based on our growing knowledge of PFAS and environmental health may help ensure patients have the greatest success with this weight loss intervention.”
The USC team has previously found that teens with higher PFAS levels also tend to regain more weight after bariatric surgery, further emphasizing the complex interplay between environmental toxins and metabolic health. Future research, led by postdoctoral research fellow Brittney Baumert, PhD, MPH, will focus on identifying the biological mechanisms by which PFAS exposure influences metabolism and recovery, utilizing metabolomics and proteomics to analyze small molecules and proteins in the body.
“This is another step toward understanding the relationship between PFAS and type 2 diabetes, including differences between types of PFAS and the role of patient age, sex and lifestyle,” explained Elizabeth Costello, PhD, a research scientist at the Brown University School of Public Health. “but many questions remain unanswered.”
Vaia Lida Chatzi, MD, PhD, professor of population and public health sciences and pediatrics and director of the ShARP Center, emphasized that metabolic recovery is not solely persistent by clinical treatment. “This study adds to growing evidence that PFAS can interfere with the body’s ability to regulate glucose, even after substantial weight loss,” she said. “The findings underscore that metabolic recovery is shaped not only by clinical treatment but also by environmental factors.” The ShARP center’s ongoing work aims to identify and address these hidden barriers to metabolic health, particularly during the critical period of adolescence.
Source: Keck School of Medicine of USC
Journal reference: Costello, E., et al. (2025).PFAS and Altered Glucose Homeostasis in Adolescents following Bariatric Surgery. Environmental Endocrinology. DOI: 10.1093/enendo/wkaf003. https://academic.oup.com/enendo/advance-article/doi/10.1093/enendo/wkaf003/8322887
