In response to the obesity pandemic, bariatric surgery (BS) is increasingly performed to obtain durable weight loss. However,
multiple recent studies have indicated that BS increases the risk for alcohol use disorder. My team recently described that patients after bariatric surgery can develop alcoholic liver disease (ALD). ALD develops at a younger age in these patients and is clinically more severe in comparison with patients without BS. A follow-up study of this clinical entity of post-BS ALD will be conducted by analyzing a large retrospective liver transplant dataset as well as setting up a nationwide prospective cohort including patients with advanced alcoholic liver disease and a history of BS. The prevalence of post-BS ALD is expected to increase considerably in the coming years. On the other hand, there is no therapy available to halt or reverse this process of liver failure apart from liver transplantation.

Unraveling the underlying pathophysiology by optimization of a mouse model will allow the development of preventive and/or therapeutic interventions. The therapeutic potential of peroxisome proliferator activated receptors (PPAR) in fatty liver diseases is clearly demonstrated by my team and will be translated to this novel clinical entity.