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How are liver disease and obesity connected?

Obesity is associated with a range of health conditions that can significantly affect your well-being. One of the most serious of these conditions is fatty liver disease, where excess fat accumulates in the liver and damages its ability to function properly. 

There are two main types of fatty liver disease:

  • Alcohol-associated liver disease occurs when an individual consumes alcohol in excess and usually over a long period of time. This damages the liver and extra fat cells build up in the liver.
  • The more common form is not related to alcohol use. Previously known as non-alcoholic fatty liver disease (NAFLD), this condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). This change reflects a better understanding of how metabolic health—not alcohol—is the key factor.

Obesity is the leading risk factor for MASLD. In fact, up to two-thirds of people with MASLD also live with obesity. The buildup of fat in the liver over time may lead to a more serious condition called MASH (metabolic dysfunction-associated steatohepatitis) that is accompanied by inflammation and fibrosis (bands of scar tissue in your liver), progressing to cirrhosis (chronic liver failure) and eventually liver failure.

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Importantly, MASLD is also linked to increased risk of cardiovascular disease, which remains the leading cause of death in people with these diseases.

The good news? Lifestyle changes, such as weight loss, healthier eating, and regular physical activity, can significantly improve liver health and reduce your risk of serious complications.

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References
  1. WebMD. Obesity and Fatty Liver. 2025. Available at: https://www.webmd.com/fatty-liver-disease/obesity-and-fatty-liver. Retrieved August 1, 2025.
  2. Quek J, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20-30.
  3. Sebastiani G, et al. Integrating the Care of Metabolic Dysfunction-associated Steatotic Liver Disease Into Cardiac Rehabilitation: A Multisystem Approach. Can J Cardiol. 2025.
  4. Sanyal AJ, et al. Cardiovascular disease in patients with metabolic dysfunction-associated steatohepatitis compared with metabolic dysfunction-associated steatotic liver disease and other liver diseases: A systematic review. Am Heart J Plus. 2024;41:100386.

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