Is cholesteral still a problem with high malabsorption procedures such as distal?

I've wondered about procedures that restrict absorption of fats and sugars....wouldn't high intake of these foods still promote heart disease or diabetes? Some people say they can (and do) eat whatever they want and still lose. I still feel that a diet high in fats and sugar would be less than healthy even if the weight gain issue is taken away? This isn't to slam any procedure, they all seem miraculous to me. This is just a very real question that I've wondered about for a long time. I have alot of heart disease and diabetes in my family and weight loss in and of itself isn't my only goal. Thanks.

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