Obesity and Liver Disease

Obese people may be suffering from wide range of comorbidities, together called as Metabolic Syndrome. Almost all the systems of the body are affected due to fat deposition and underlying inflammatory response in obese people. This varies from hypertension and heart diseases (Cardiac), diabetes (Pancreas), obstructive sleep apnoea and snoring (Respiratory), Polycystic ovarian disease, menstrual disturbances and infertility (Reproductive), osteoarthritis and disc prolapse (Musculoskeletal) to fatty liver and gallstones (Hepatobiliary).

Obesity is defined on the basis of Body Mass Index (BMI). BMI is classified into Normal (18.5 -24.9 kg/m²), Overweight (25.0-29.9kg/m²), Class I Obesity (30.0-34.9kg/m²), Class II Obesity(35.0-39.9kg/m²), Class III or Morbid obesity (40.0-49.9kg/m²) and Super morbid obesity (>50.0kg/m²).

Non-alcoholic Fatty Liver Disease (NAFLD) is a common finding affecting 80-100% of obese people, which represents hepatic component of metabolic syndrome. NAFLD remains quiescent for long period of time with normal liver function tests.Ultrasonography is a simple, reliable and low-cost tool for the evaluation of liver involvement in metabolic syndrome. NAFLD may gradually progress to Non-alcoholic Steatohepatitis (NASH) where inflammation and fibrosis of liver parenchyma occurs. Patients with NASH still have no symptoms but may have deranged liver function tests.NASH progresses to Liver cirrhosis, which takes 5-10 years to set in, but this is an irreversible stage which is progressive in nature leading to a clinical situation where liver transplant is the only solution.NASH is now the second commonest cause of cirrhosis leading to liver transplantation. Apart from this, NASH predisposes to liver cancer (HCC).

Pharmacologic treatment of NAFLD and NASH are not very effective. Prevention of obesity is the most effective tool for prevention of liver disease. That’s why creating awareness about this condition is very important. Adopting a healthy eating pattern and exercise have a plethora of benefits and maintaining healthy liver is one of them.

Morbidly obese people may require bariatric surgery which provides sure, effective and permanent weight loss. This provides obese people an opportunity to attain better, healthier and active lifestyle.