Obesity, Liver Disease, and the Patient Voice: A Clinical Dialogue Podcast.

Obesity is a chronic, progressive disease defined by excess adiposity that can negatively affect a person's health. Approximately one billion people are living with obesity globally, though this estimate is shaped by the ongoing evolution in how the condition is measured and diagnosed. Although obesity is traditionally diagnosed by body mass index (BMI), it does not adequately assess body fat distribution, particularly visceral fat, which is specifically linked to an increased risk of poor metabolic health and cardiovascular disease. Other anthropometric measures such as waist circumference and waist-to-height ratio assess an indirect measure of visceral adiposity and are better predictors of cardiovascular risk than BMI alone. Obesity can increase the risk of developing type 2 diabetes, lipid dysfunction, and metabolic dysfunction-associated steatotic liver disease (MASLD), a condition in which the liver stores too much fat because the body's metabolism is not working properly. Around 75% of people with obesity have MASLD, with 12% to 40% progressing to metabolic dysfunction-associated steatohepatitis (MASH; the advanced form of MASLD) within 8-13 years. MASH and MASLD are largely underdiagnosed because someone affected by these conditions does not show symptoms. In this podcast, a patient and doctor specialising in obesity medicine share their perspective on the experience and best practice relating to the diagnosis of obesity, the need for screening of obesity complications, and the importance of the assessment and management of liver health as part of a holistic delivery of obesity care.Podcast available for this article. Podcast (MP4 156963 kb).