Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are highly effective for reducing hepatic steatosis in patients with severe obesity and type 2 diabetes (T2D), with almost complete clearance of liver fat 1 year after surgery, according to a study published in the Annals of Internal Medicine. Researchers compared the 1-year effects of SG and RYGB on hepatic steatosis and fibrosis in a single-center randomized controlled trial involving 100 patients with T2D (mean BMI, 42 kg/m2) from a tertiary care obesity center. Participants were randomly assigned in a 1:1 ratio to SG or RYGB. From surgery to 1-year follow-up, the decline in liver fat fraction was similar after SG and RYGB (−19.7% and −21.5%, respectively); at 1 year, almost all patients had no or low-grade steatosis (SG, 94%; RYGB, 100%). In 77% of patients, the enhanced liver fibrosis score category remained stable; however, at 1 year, 18% experienced worsening of fibrosis, with no substantial difference between the groups.