A new study from the University of Southern California (USC) has found that exposure to certain man-made chemicals called PFAS may reduce the benefits of weight-loss surgery in teens—especially when it comes to long-term blood sugar control.
The study focused on teens who had undergone bariatric surgery and showed that those with higher levels of PFAS in their blood before surgery had smaller improvements in key blood sugar markers over five years.
PFAS stands for per- and polyfluoroalkyl substances. These chemicals are used in many everyday products, like non-stick cookware, waterproof clothing, and food packaging. They can build up in the body over time and have been linked to health issues like cancer, liver and kidney problems, and hormone disruption.
Nearly all adults in the U.S. have detectable levels of PFAS in their blood, and more research is showing that PFAS may also be connected to metabolic problems like type 2 diabetes.
The USC research team, part of the ShARP Center (Southern California Superfund Research and Training Program for PFAS Assessment, Remediation and Prevention), looked at data from the Teen-LABS study.
This is a long-term study that follows teens who have had bariatric surgery. The researchers studied 186 teens who had their PFAS blood levels measured before surgery and tracked their metabolic health for five years.
They found that teens with higher levels of PFAS had smaller improvements in their fasting glucose and HbA1c levels. These two measures are important indicators of blood sugar control. HbA1c reflects average blood sugar over the past two to three months, and fasting glucose measures sugar in the blood after not eating.
The results showed that the metabolic benefits of the surgery may fade more quickly in those with high PFAS exposure.
One PFAS chemical stood out in the findings—PFHxS (perfluorohexanesulfonic acid). Teens with more PFHxS in their blood saw an average yearly increase of 0.15 percentage points in their HbA1c levels.
This means that even after successful surgery, their blood sugar could move from normal to prediabetes—or from prediabetes to type 2 diabetes—within just a few years. Fasting glucose also rose by about 1 mg/dL each year, potentially wiping out the initial improvements seen after surgery within a decade.
While the researchers didn’t find a clear link between PFAS levels and insulin after surgery, they believe more research is needed to explore that connection. The study highlights the importance of understanding how environmental exposures like PFAS can affect recovery and outcomes after major treatments like weight-loss surgery.
The researchers say that testing for PFAS levels before surgery could help doctors identify which teens are at higher risk of losing the surgery’s benefits. These teens could then receive extra support, closer monitoring, or additional treatments to keep their blood sugar levels in check.
Dr. Brittney Baumert, one of the lead authors, said this study shows why doctors and environmental scientists need to work together. Understanding how pollution and toxins affect the body could help create better, more personalized treatments for young patients.
Dr. Vaia Lida Chatzi, director of the ShARP Center, emphasized that recovery from surgery is shaped not just by medical care, but also by the invisible influence of harmful chemicals in our environment. This research adds to growing evidence that PFAS can interfere with blood sugar control, even after major weight loss.
In summary, this study suggests that PFAS exposure may weaken the long-term benefits of bariatric surgery in teens, especially in managing blood sugar. More research is needed, but these findings point to the importance of screening for environmental toxins and providing personalized care based on each patient’s unique risk factors.
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The study is published in Environmental Endocrinology.
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