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How Obesity Affects Your Liver

Obesity is rapidly overtaking alcohol as one of the major causes of fatty liver disease.

The term non-alcoholic fatty liver disease (NAFLD) is now widely used to describe hepatic steatosis resulting from excess weight in the absence of a history of significant alcohol use or other known liver diseases.

Already NAFLD is one of the most common liver disease worldwide with approximately 30% of the population affected in industrialized, western countries.

But how exactly does excess weight lead to a fatty liver and how damaging is this effect on liver function?

This is the subject of a comprehensive review by Alexander Wree and colleagues from the University of Duisburg-Essen, Germany, published in the latest issue of DIGESTION.

As the authors point out, visceral adipose tissue secretes free fatty acids (FFAs) and hormones (adipokines) that appear to play a major role in the development of NAFLD. Toxic FFAs can activate the intrinsic apoptosis pathway in hepatocytes (via c-Jun N-terminal kinase_mediated Bax activation) in a process known as ‘lipoapoptosis’. Not surprisingly, apoptotic cell death is a prominent feature in the progression of NAFLD to nonalcoholic steatohepatitis (NASH).

In addition, reduced adiponectin levels commonly associated with obesity may establish a proinflammatory milieu, thus increasing vulnerability to lipotoxicity, which promotes progression from simple steatosis to NASH and even advanced hepatic fibrosis.

Interestingly, obesity also appears to be a significant and independent risk factor for hepatocellular carcinoma, the most frequent type of liver cancer.

There is also data to suggest that excess body weight can adversely affect the progression of chronic hepatitis C and B.

Fortunately, NAFLD is a treatable condition, which responds (often dramatically) to weight loss interventions.

Thus, some readers may be aware that many bariatric surgeons now routinely recommend two weeks of weight loss prior to laparoscopic surgery, as this has been shown to dramatically reduce liver size and improve visibility during the surgical procedure.

As for so many other obesity related conditions, preventing and treating obesity will be a key measure in preventing and controlling this epidemic of fatty liver disease.

Edmonton, Alberta

Wree A, Kahraman A, Gerken G, & Canbay A (2010). Obesity Affects the Liver – The Link between Adipocytes and Hepatocytes. Digestion, 83 (1-2), 124-133 PMID: 21042023


  1. Good day Dr Sharma,
    Who would of thought that eating could make your liver worst than drinking. This info should make people aware that drinking & driving is not the only promotion we should be making public. Eating and driving will become as relevant.
    Most obese people do not want to be obese, all they want is to understand what is going on and they need a support system to get them healthy, quickly.
    Thee Quest For Perfect Health was created to guide and be a compass for all people wanting to change. I do say “wanting” to change.
    What do we do with all that do not connect to that Doc.?
    Thanks for being who you are.
    I hope people listen to you,
    Pierre & Pierrette

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  2. One more reason to ban sugar, especially fructose. We can stop using it in any form. Remember that the liver is the primary processor of fructose, converting fructose to fats (triglycerides). Sugar is 50% fructose/50% glucose after splitting. HFCS is ~50% glucose and ~50% in suspended in water.


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  3. Dear doctor Sharma:
    I know of several people who passed away from liver cancer who were not drinkers and reading today’s srtical brought back many memories of these individuals. They were over weight for a long time–and no one could figure out just why they got liver cancer when they did not drink. One of them smoked quiet a bit and I figured that was why but now I understand that it was not smoking that caused the cancer.

    As research expands we may well find out more, more frightening things about being overweight. In the meantime those of us who know that excess weight is unhealthy versus just unsightly there will be more people actively working at shedding pounds.

    I woulder if there is an herdity link with NAFLD just like there is with many other cancers. Thanks agian

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  4. Dear sir, Your artice ‘How Obesity Affects your iver’ is wonderful…..but i request you kindly to give more inputs in that obesity can adversely affects the progression of Heptitis B and C. Thanks

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  5. It seems that being obese is a nightmare for the liver health. And as mentioned, it’s not only about alcohol, but what you eat matters too! More pounds of weight will make fatty liver more likely. So we all need to concern that maintaining healthy weight, especially waistline, is so crucial to prevent liver damage!

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