PFAS Exposure Predicts Weight Gain After Metabolic Surgery

A new study in Obesity provides another piece of the puzzle of the influence of PFAS in obesity. PFAS is shorthand for per- and polyfluoroalkyl substances. People also refer to them as “forever chemicals” because they accumulate in our environment and our bodies. The new study tells us that PFAS exposure in teens having metabolic surgery is associated with more weight regain after surgery in teens.

In other words, it may be that PFAS exposure makes adolescents more resistant to the benefits of obesity treatment.

Observational Research from Teen-LABS

This finding comes from observational research using data from the Teen-LABS study of bariatric surgery. Brittney Baumert and colleagues analyzed data from 186 adolescents who underwent surgery between 2007 and 2012. They had anthropometric data for five years after surgery, as well as baseline measures of PFAS blood levels for seven different kinds of these substances.

Higher concentration of three of those substances had a significant association with less weight loss, greater weight regain, and increased waist circumference from one to five years after surgery.

Consistent with Findings from a Dietary Study

These new findings line up with observations from an earlier study of the relationship between weight regain after a dietary intervention. Philippe Grandjean and colleagues found in 2023 that people with higher PFAS levels had more weight gain after a dietary weight loss program.

Of course, these are observational studies. Residual confounding makes it possible that other factors are at work in these findings. But it is clear enough that PFAS exposure disrupts endocrine function and thus can influence body weight.

Drug and Chemical Exposures

This should be an important reminder that glib assertions about a “root cause” for the rise in obesity should be cause for skepticism. Most often people presume that obesity results from a poor diet. Ultra-processed foods are the most popular suspects currently.

But the truth is that the causes for obesity are many and overlooking the influence of endocrine disrupting drugs and chemicals is a mistake.

Thus, we lament the mistake of walking away from international negotiations this week without an agreement to limit plastics pollution. It is a serious mistake to continue filling our air and water with chemicals and plastic particles that contribute to the metabolic problems we face.

Click here for the new study in Obesity, here and here for further perspective.

Toxic Smoke over Hampstead Heath from the Buncefield Fire, photograph by Justin Cormack, licensed under CC BY-SA 2.0

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August 17, 2025