Obesity and the Liver

By Joshua Ng (Pharmacist, Caring Pharmacy) | Malaysia | Thu Mar 29, 2018 5:51pm


An Introduction

The liver is a very important organ. However, there are various reasons the liver can be damaged such as excessive alcohol intake, being overweight, smoking and consuming certain medications. This article focuses on the risk of liver disease in the overweight and obese.

Overweight and Obesity Definition

The body mass index (BMI) is used to classify overweight and obesity. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2). The World Health Organization (WHO) defines overweight as a BMI of ≥25 and a BMI of ≥30 for obesity.1

Non-Alcoholic Fatty Disease

Non-alcoholic fatty liver disease (NAFLD) is a condition where there is a build-up of fats in the liver, resulting in an inflammatory process leading to liver tissue scarring and ultimately liver failure. This condition is commonly seen in those who are overweight or obese.2

How Fats Damage the liver

There are various theories on how fat build-up damages the liver3:
Theory#1: An overweight/obese patient usually develops insulin resistance. The body is unable to break down fatty acids. This results in accumulation of bad fats (steatosis) in the hepatocytes (liver cells).
Theory#2: The excessive fatty acid causes oxidative stress unto the liver, thereby resulting in tissue scarring and liver damage.

The Magnitude of the Problem in Malaysia

  1. A 2006 research paper noted the prevalence of NAFLD among Asia pacific countries is in a range of 5-30%. The paper noted Malaysia’s NAFLD prevalence was at 17%, in comparison Singapore was at 5%, whereas Indonesia was about 30%.4
  2. A 2015 research paper conducted in Malaysia found that low physical activity and high intake of fatty foods is associated with NAFLD in obese patients.5
  3. The same paper noted that NAFLD is common in the centrally obese group, (obese men with waist circumference >90cm and obese women with waist circumference >80cm).5
  4. A news report in 2017 showed Malaysia is has the highest obesity prevalence in South East Asia. 13.3% are obese and 38.5% are overweight.6


The facts above indicate clearly that Malaysians are at high risk of developing liver failure. The problem of obesity contributes greatly to this. Apart from liver failure, obesity is associated with various metabolic syndromes such as diabetes, hypertension and hypercholesterol. Hence, the need to tackle obesity in our community. It is vital that we proactively adopt a healthy diet and exercise regularly to control our weight and waist line, and in extension protect our liver!

  1. Obesity. Health Topics. WHO (2018). Weblink: http://www.who.int/topics/obesity/en/
  2. Non-alcoholic fatty liver disease (NAFLD). NHS Choices (2016). Weblink: https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
  3. Non-alcoholic fatty liver disease in 2015. Monjur Ahmed. (2015) World Journal of Hepatology.
  4. How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences? DA Amarapurkar, E Hashimoto, KL Goh, et al. (2007) Journal Gastroenterology and Hepatology.
  5. Low physical activity and energy dense Malaysian foods are associated with non-alcoholic fatty liver disease in centrally obese but not in non-centrally obese patients with diabetes mellitus. WK Chan, ATB Tan, KL Goh, et al. (2014) Asia Pacific Journal Clinic Nutrition.
  6. Malaysians most obese in region. FH Rashid (2017). New Straits Times. Web Article: https://www.nst.com.my/news/nation/2017/06/246538/malaysians-most-obese-region




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