Cohort studyindependent cross-checkabstract checked I-BAR-140 standard review
Israeli study: rheumatoid arthritis after surgery
The association between bariatric surgery and incident rheumatoid arthritis.
Overview
Jeries et al.. Rheumatol Adv Pract 2026 · PMID 41908723 · DOI 10.1093/rap/rkag025
Rheumatoid arthritis appeared equally rarely in operated and non-operated people (9 cases each).
Does the study support the specific claim? No · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
RA after surgery
- How was the study done?
Matched cohort
- How many people, animals or samples were studied?
19,166
- What was actually found?
9 vs 9 cases
- How large was the observed effect?
No difference
- What do the results mean in everyday life?
No sign of more arthritis
- What are the study's limitations?
Very few cases
- What does it say about Elawady's specific claim?
Contradicts the RA part
- Do the results apply to Germany and Europe?
Plausible
- What can explicitly not be concluded from this study?
Small effects
Scientific in-depth review
1. Full reference
- Authors
- Jeries et al.
- Journal
- Rheumatol Adv Pract
- Year
- 2026
- Identifier
- PMID 41908723 DOI 10.1093/rap/rkag025
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref API
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Does weight loss after bariatric surgery change the incidence of rheumatoid arthritis?
3. Study design and population
- Study design
- Cohort study – Retrospective matched cohort (Maccabi Healthcare Services)
- Population
Patients with bariatric surgery 2010-2015 and age/sex-matched controls
- Country
Israel
- Period
2010-2020
- Sample size
19,166 (9,583 per group)
- Inclusion and exclusion criteria
RA confirmed by rheumatologist, serology or DMARD purchase
4. Methods and endpoints
- Exposure / intervention
Bariatric surgery
- Comparator
Age/sex-matched controls
- Endpoints
Incident RA
- Statistical methods
Incidence comparison
5. Actual results
- Results
18 incident RA cases: 9 in each group over mean 7.31 y.
- Absolute risks
9/9583 in each group (~0.1%).
- Authors' conclusion
Bariatric surgery was not associated with reduced RA risk over 10 years.
6. Strengths
- Strict RA definition
7. Weaknesses
- Very few events; underpowered
- Controls matched only on age and sex
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Low event count.
9. Assessment of the statistical interpretation
9 vs 9 events: no difference, but very imprecise.
10. Relevance to the specific claim
No increase in RA after surgery (consistent with SOS, I-INTC-09).
11. Independent contrary findings
Underpowered.
12. Transferability to Germany and Europe
Israeli data.
13. Overall methodological judgement
Weak evidence of no RA increase.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Other autoimmune diseases.
15. Linked fact checks
- Sleeve gastrectomy causes autoimmune diseases and fibromyalgia. – Studies contradicting or limiting the claim