Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Potentially false Certainty of evidence: low provisional C-BAR-13

Sleeve gastrectomy causes autoimmune diseases and fibromyalgia.

Conclusion: Probably false: no increase in rheumatoid arthritis was found and fibromyalgia may improve after weight loss; a weak, unproven signal exists for inflammatory bowel disease.
  1. Original statement
  2. Scientific assessment
  3. In plain language
  4. Studies on this claim
  5. Regional context
  6. What applies in my country?
  7. References

Original statement

التكميم يعمل فايبروميولجيا

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Sleeve gastrectomy causes autoimmune diseases and fibromyalgia.

Origin

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! مقاومة الأنسولين ٢ (Open source)
Published
1 July 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Claimed mechanism

Undigested food, abdominal pressure and inflammation.

Claimed health effect

Autoimmune disease, fibromyalgia.

Population concerned

Sleeve patients

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
اتفرجوا عالبودكاست ده وقولولي رأيكوا عشان انزلكوا الحلقه التانيه منه (Open source)
Published
9 April 2026
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.

Scientific assessment

Potentially false – The available evidence tends to speak against the statement, but is not conclusive.

Certainty of evidence: low – Further research is likely to change the assessment considerably.

1. What was claimed?

Sleeve causes autoimmune disease and fibromyalgia.

2. What is demonstrably correct?

There is a weak signal: some studies report new inflammatory bowel disease (an immune-mediated disease) after bariatric surgery, including sleeve gastrectomy, but frequency and causation are not established (I-INTC-10).

3. What is wrong or exaggerated?

The general claim that sleeve gastrectomy causes autoimmune diseases is not supported: no increase in rheumatoid arthritis was found over up to 29 years (I-INTC-09). For fibromyalgia, the available evidence points in the opposite direction: obesity is associated with worse symptoms and weight loss, including surgery, may improve them (I-INTC-11).

4. What remains unclear?

Data specific to sleeve gastrectomy are scarce; the SOS surgery group had gastric banding (19%), vertical banded gastroplasty (68%) and gastric bypass (13%) and no sleeve gastrectomy at all, rheumatoid arthritis was not a predefined endpoint, and the authors state the study may be underpowered (I-INTC-09). The frequency of de novo IBD after surgery compared with the expected rate is unknown. Other autoimmune diseases were not studied in the sources found.

5. Which studies support it?

I-INTC-10 (de novo IBD reported in some patients; no rates).

6. Which studies contradict it?

I-INTC-09 (no association with RA: HR 0.92, 0.59-1.46); I-INTC-11 (weight loss including bariatric surgery may improve fibromyalgia; obesity prevalence 35.7% among people with fibromyalgia).

7. What applies to Germany and Europe?

Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.

8. What is known about Egypt?

No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.

9. What practical conclusion is appropriate?

Fear of autoimmune disease or fibromyalgia is not, on current evidence, a reason to reject bariatric surgery; the established risks (reflux, deficiencies, need for follow-up) should be discussed with the surgical team.

Assessment details

Rationale for certainty of evidence

A targeted search found direct evidence: in the Swedish Obese Subjects study, bariatric surgery was not associated with rheumatoid arthritis over a median of 21 years (HR 0.92, 95% CI 0.59-1.46; I-INTC-09); this is indirect for sleeve gastrectomy because no SOS patient had a sleeve, and RA was not a predefined endpoint. A systematic review reports preliminary evidence that weight loss, including bariatric surgery, improves fibromyalgia symptoms (I-INTC-11). A systematic review reports de novo inflammatory bowel disease in some patients after bariatric surgery, without rates or proof of causation (I-INTC-10). Evidence is observational and mostly not specific to sleeve gastrectomy, so certainty is low.

Source quality

Assertion without cited data.

Regional transferability

n/a

Individual exceptions

n/a

Regional scope of the claim
general (biological/medical)
Last reviewed
25 October 2026 provisional

In plain language

Elawady said that sleeve gastrectomy causes autoimmune diseases and fibromyalgia. A long Swedish study found that weight-loss surgery did not increase rheumatoid arthritis over about 21 years. For fibromyalgia, early studies suggest that losing weight, including through surgery, may ease symptoms. Some reports describe new inflammatory bowel disease after weight-loss surgery, but it is not known how often this happens or whether surgery causes it.

Studies on this claim

Studies supporting the claim (0)

No studies in this group.

Studies contradicting or limiting the claim (2)

  • Weight-loss surgery and rheumatoid arthritis

    Maglio C et al.. Rheumatology (Oxford) 2020 · PMID 31321442 · DOI 10.1093/rheumatology/kez275
    Cohort studyindependent cross-checkfull text checked★ key study

    Over a median of 21 years, people who had weight-loss surgery did not develop rheumatoid arthritis more often than matched controls.

    No increase in rheumatoid arthritis after bariatric surgery (HR 0.92).

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test bariatric surgery and RA incidence

    How was the study done?

    Matched cohort

    How many people, animals or samples were studied?

    4036 adults with obesity

    What was actually found?

    No association

    How large was the observed effect?

    HR 0.92 (0.59-1.46)

    What do the results mean in everyday life?

    Surgery did not raise the risk of rheumatoid arthritis.

    What are the study's limitations?

    Few cases; older surgery types; not randomised

    What does it say about Elawady's specific claim?

    Contradicts 'surgery causes autoimmune disease' for RA

    Do the results apply to Germany and Europe?

    High

    What can explicitly not be concluded from this study?

    Effects of sleeve gastrectomy specifically; other autoimmune diseases

    Scientific details →

  • Fibromyalgia and obesity

    D'Onghia M et al.. Semin Arthritis Rheum 2021 · PMID 33676126 · DOI 10.1016/j.semarthrit.2021.02.007
    Meta-analysisindependent cross-checkabstract only checked

    About one in three people with fibromyalgia has obesity; early studies suggest weight loss, including surgery, may ease symptoms.

    Weight loss (incl. surgery) preliminarily improves FM symptoms.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Review FM and obesity

    How was the study done?

    Systematic review and meta-analysis

    How many people, animals or samples were studied?

    41 studies

    What was actually found?

    Obesity common in FM; weight loss may help

    How large was the observed effect?

    Obesity prevalence 35.7% (31.8-39.9%)

    What do the results mean in everyday life?

    Losing weight may help fibromyalgia.

    What are the study's limitations?

    High risk of bias; few weight-loss studies

    What does it say about Elawady's specific claim?

    Does not support 'surgery causes fibromyalgia'

    Do the results apply to Germany and Europe?

    High

    What can explicitly not be concluded from this study?

    Proof of benefit or harm from sleeve gastrectomy

    Scientific details →

Studies with mixed or unclear results (1)

  • Bowel inflammation after weight-loss surgery

    Mian A et al.. Surgeon 2023 · PMID 35660070 · DOI 10.1016/j.surge.2022.04.008
    Systematic reviewindependent cross-checkabstract only checked

    Some studies report new inflammatory bowel disease after weight-loss surgery, but how often and whether surgery causes it is unknown.

    De novo IBD reported after bariatric surgery; causation and rate unknown.

    Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Review bariatric surgery and IBD

    How was the study done?

    Systematic review of 22 studies

    How many people, animals or samples were studied?

    Patients with/without IBD

    What was actually found?

    Safe in IBD; de novo IBD reported

    How large was the observed effect?

    not reported

    What do the results mean in everyday life?

    A possible rare link exists but is unproven.

    What are the study's limitations?

    Weak study types; no rates

    What does it say about Elawady's specific claim?

    Weak partial support

    Do the results apply to Germany and Europe?

    High

    What can explicitly not be concluded from this study?

    Causation

    Scientific details →

Regional context

Germany / EU

Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.

Egypt

No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.

What applies in my country?

General scientific assessment

Potentially false Probably false: no increase in rheumatoid arthritis was found and fibromyalgia may improve after weight loss; a weak, unproven signal exists for inflammatory bowel disease.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Bariatric surgery and the incidence of rheumatoid arthritis - a Swedish Obese Subjects study.. Maglio C et al.. Rheumatology (Oxford) 2020 · PMID 31321442 · DOI 10.1093/rheumatology/kez275
  2. Fibromyalgia and obesity: A comprehensive systematic review and meta-analysis.. D'Onghia M et al.. Semin Arthritis Rheum 2021 · PMID 33676126 · DOI 10.1016/j.semarthrit.2021.02.007
  3. Systematic review: Outcomes of bariatric surgery in patients with inflammatory bowel disease and de-novo IBD development after bariatric surgery.. Mian A et al.. Surgeon 2023 · PMID 35660070 · DOI 10.1016/j.surge.2022.04.008

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