It is well-known that excessive alcohol consumption is detrimental to liver health. However, obesity is also a significant contributor to liver conditions.
What is obesity?
Obesity is the condition of having excess fat in the body. A normal amount of body fat percentage is 25-30% in women and 18-23% in men – any body fat percentage over the normal range is an indication of obesity. Some people prefer using the body-mass index (BMI) as an indicator of body fat, as it is easier to measure without specialised equipment, although it is less accurate. As a general indication, a person with a BMI of 30 and above is considered to be obese.
For a while now, doctors over the world have been labelling obesity as an epidemic. Perpetuated by sedentary lifestyles and poor diets, the condition is affecting vast populations in developed nations around the world. Obesity is worrisome as it is a contributor to many types of health conditions, such as type 2 diabetes, coronary heart disease, high blood pressure, higher risk of strokes, gout, gallstones, colon cancer, and fatty liver disease.
How does obesity affect liver health?
A range of liver diseases under the name non-alcoholic fatty liver disease (NAFLD) is caused by obesity. Statistics place NAFLD as the most common liver disease worldwide, affecting 10-24% of the world’s population. While the exact mechanism by which obesity leads to liver disease is not known, it is commonly thought that obesity contributes to insulin resistance, which in turn causes the onset of these liver conditions.
NAFLD and obesity are also closely tied in terms of the degree of liver damage. This means that a higher obesity or higher BMI typically leads to greater liver damage. The range of conditions under NAFLD can be classified in varying stages of severity. These are listed in increasing order below:
- Simple fatty liver (steatosis): Steatosis is a build-up of excess fat (more than 5%) in the liver. This condition usually shows no symptoms and is diagnosed incidentally when tests for other conditions are being conducted.
- Non-alcoholic steatohepatitis (NASH): NASH is a more advanced form of NAFLD in which inflammation occurs in the liver. However, it is still relatively low-grade and many people live with it with little or no symptoms for years.
- Fibrosis:When liver inflammation persists, scar tissue is repeatedly formed and builds up around the liver and surrounding blood vessels. Although the condition is more serious, the liver can still function at this stage.
- Cirrhosis:After years of inflammation, the liver starts to shrink and becomes scarred and lumpy. At the most severe form of NAFLD, liver damage is permanent and can lead to failure of liver functions and liver cancer. Other condition, such as infections of hepatitis B and hepatitis C, can also lead to cirrhosis.
How is NAFLD diagnosed?
NAFLD at its early stages does not show any symptoms. If any, the symptoms reported are non-specific, such as lethargy, nausea, or a dull ache at the right abdomen under the ribs. Thus, NAFLD is usually only spotted during other routine tests or examinations for other conditions. For example, routine blood tests may show up with elevated levels of liver enzymes, prompting a diagnosis for NAFLD. Ultrasound examination of the abdomen for other purposes can also detect fatty liver.
As the disease progresses in severity, more symptoms will start to show up. At the cirrhosis stage, symptoms can range from swelling of the legs, bleeding from esophagal veins, accumulation of fluid in the abdomen, and mental confusion.
Who is at risk of NAFLD?
Certain lifestyle factors and pre-existing health conditions can put one at higher risk of contracting NAFLD. These are:
- Obesity, especially if fats are concentrated at the visceral area
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Metabolic syndrome (a combination of diabetes, high blood pressure and obesity)
- Age of 50 years and above
What can you do to reduce the risk factors?
If you are already obese, you can reduce your chances of developing NAFLD by losing weight. You can do this through exercising and maintaining a healthy diet. Ideally, this means reducing your consumption of refined carbs, opting instead to eat wholegrain foods, and foods that are low in sugar and fat.
For those who are already diagnosed with NAFLD, losing weight is also the primary treatment method to prevent further deterioration and promote recovery. A 10% weight loss is enough to lead to a significant drop in liver enzyme levels. However, care should be taken not to undergo extreme diets that lead to a drastic reduction in weight, as this puts extra stress on the liver and other parts of the body.
As can be seen, obesity is a major contributor to liver disease. Take care of your liver health by taking steps to maintain a healthy weight and active lifestyle. To learn more about liver diseases, you may consult a gastroenterology specialist for a personalised consultation.