Liver Disease and Weight

What is liver disease?

The liver is the second-largest organ after the skin in humans. It sits under the rib cage on the right side and is about the size of a football.

Liver disease refers to several conditions that can affect and damage the liver. Liver disease can cause scarring. As more scar tissue replaces healthy tissue, the liver can no longer work properly. Not treated on time may lead to liver failure and liver cancer.

What are the symptoms of liver disease?

The most common symptom of liver disease is jaundice which leads to the yellowing of your skin and the whites of your eyes. Jaundice develops when your liver can’t clear bilirubin.

Other symptoms of liver disease may include:

• Abdominal pain (especially on the right side)
• Bruising easily
• Nausea or vomiting
• Changes in the colour of urine
• Fatigue
• Changes in the colour of stool
• Swelling in arms or legs (edema)⁴

The link between chronic liver disease and weight

Obesity is a risk factor for liver disease ²

Nonalcoholic fatty liver disease is related to an increased risk of obesity (NAFLD). When the rate of hepatic fatty acid intake from plasma and de novo fatty acid synthesis is higher than the rate of fatty acid oxidation and export, steatosis, the defining characteristic of NAFLD, develops (as triglyceride within VLDL). In light of this, an imbalance in the intricate interconnections of metabolic activities is represented by an excessive quantity of intrahepatic triglyceride. Steatosis is linked to a number of unfavourable changes in the metabolism of glucose, fatty acids, and lipoproteins.

Insulin resistance, dyslipidemia, and other cardiometabolic risk factors associated with NAFLD are likely to develop due to abnormalities in fatty acid metabolism, in addition to adipose tissue, hepatic, and systemic inflammation. It is unclear, however, whether IHTG buildup results from metabolic dysfunction, which may or may not be caused by NAFLD. Information about the processes behind the cardiometabolic consequences of obesity will be gained by knowing the specific components involved in the development and pathophysiology of NAFLD.

Nonalcoholic fatty liver disease (NAFLD), which is defined by an increase in intrahepatic triglyceride content (i.e., steatosis) with or without inflammation and fibrosis, is linked to obesity and a range of liver disorders (i.e., steatohepatitis). Due to its high incidence, the potential for development to severe liver disease, and associations with major cardiometabolic abnormalities such as type 2 diabetes mellitus (T2DM), metabolic syndrome, and coronary heart disease, NAFLD has emerged as a significant public health concern (CHD).

•  A significant risk of developing T2DM, dyslipidemia (high plasma TG and/or low plasma HDL-cholesterol concentrations), and hypertension are also linked to NAFLD
• The goal of this study aims to evaluate the intricate clinical and physiological relationships between metabolic dysfunction, obesity, and NAFLD

There’s a strong link between obesity, and non-alcoholic fatty liver disease ³

The buildup of unusually high lipids in hepatocytes has been linked to obesity.¹ It has been proposed that increased lipid peroxidation, followed by stellate cell activation and collagen production, maybe the mechanism by which this hepatic steatosis causes fibrosis and cirrhosis.² Cross-sectional investigations of people with chronic hepatitis C virus infection, non-alcoholic steatohepatitis, and alcohol-induced liver disease provide evidence for this notion. According to reports from 5 and 6, obesity and severe fibrosis or cirrhosis are related. However, cross-sectional studies cannot establish whether the exposure (obesity) preceded or followed the result (cirrhosis or fibrosis). This is crucial because following the onset of cirrhosis, there may be significant variations in weight, such as weight reduction from muscle loss or weight increase from ascites and peripheral edema. Additionally, because prior research did not utilize a group of patients without chronic liver disease as a control, it is impossible to assess the potential influence of obesity in healthy individuals on developing cirrhosis and chronic liver disease later on.

By examining data from a nationally representative cohort of 11,465 individuals with an average of 13 years of follow-up evaluation, our goal was to ascertain if obesity in the general population is linked with mortality or hospitalization due to cirrhosis. 

Nonalcoholic steatohepatitis

Non-alcoholic steatohepatitis (NASH) is an accumulation of fat in the liver that results in inflammation and damage to the liver. It belongs to a disease class known as nonalcoholic fatty liver disease. You could be informed that your liver is "fatty." Most people with a buildup of liver fat do not have any symptoms or concerns. However, in certain people, the fat leads to inflammation and harms liver cells. The liver is damaged, and as a result, it doesn't function as well as it should.

Cirrhosis can develop as NASH worsens and the liver scars as a result. However, the condition doesn't always worsen.

NASH resembles the type of liver disease brought on by chronic, excessive drinking. NASH, however, also affects those who do not drink alcohol. ¹

Symptoms:

In the early stages of NASH, you might not exhibit any symptoms. Most NASH sufferers are unaware of their condition since they feel well.

You may experience symptoms like these when NASH worsens, and the liver damage increases

• Fatigue (feeling weary all the time) (feeling tired all the time)
• Loss of weight with no apparent cause
• weakness, in general
• a stomachache in the top right corner
• It could take several years for NASH to get to the point where symptoms appear

Can losing excess weight help improve symptoms of chronic liver disease?

Obesity increases the likelihood of fibrosis advancement in chronic liver illnesses such as hepatitis C and non-alcoholic fatty liver disease. This study sought to understand better the long-term effects of weight reduction on the liver's biochemistry, insulin levels in the blood, and quality of life in obese individuals with liver disease, as well as the consequences of future weight maintenance or recovery.

According to studies, decreasing 10% of your body weight results in improved liver enzymes, which are related to a decrease in the inflammation of the liver brought on by the additional fat.

Furthermore, weight loss may also improve health-related quality of life and other prognostic markers of the disease, like fibro scan, along with improvement in the associated metabolic derangements. Weight loss in obese patients with CLD would improve the clinical outcome and reduce hepatic complications.⁴

Conclusion

These data show that maintaining weight reduction and exercise in obese individuals with liver disease leads to a long-lasting improvement in liver enzymes, serum insulin levels, and quality of life. Treatment for overweight people should be a significant part of chronic liver disease treatment.