Why does this matter to you as a clinician?

Recognising the interconnectedness of obesity and liver health is critical for early identification, risk stratification, and holistic management of patients. Multidisciplinary collaboration is essential to address the full spectrum of cardio-renal-metabolic disease.

The overlap—a shared patient population with amplified risks

64.5% of UK adults are overweight or obese⁵

~75% of people living with obesity have MASLD⁴

~34% of people living with obesity have MASH⁴

What is the link between obesity and MASLD, and why is it important to address them together?

Obesity, MASLD, MASH, type 2 diabetes, cardiovascular, and renal diseases often co-exist and amplify each other’s risks. Having one CRM condition increases the likelihood of developing another, leading to higher morbidity, mortality, and healthcare costs.

Global prevalence of obesity-related complications^1,2,4-8

Global prevalence of obesity-related health complications

*Note that estimates may be even higher when obesity is defined using anthropometric measures, such as waist circumference, rather than BMI.⁸

BMI, body mass index; MASH, metabolic dysfunction-associated steatohepatitis; MASLD, metabolic dysfunction-associated steatotic liver disease.

The societal and economic toll

In 2023 to 2024, 64.5% of adults aged 18 years and over in England were estimated to be overweight or living with obesity. It is estimated that the current costs of obesity in the UK are £6.5 billion to the NHS and £27 billion to wider society. There is a clear social gradient in adult obesity prevalence across England. Rates are highest in the most deprived areas, particularly among women, where obesity affects approximately 39%, compared with 22% in the least deprived populations. This disparity reinforces the importance of proactive identification and engagement with overweight and obesity management services to help narrow health inequalities.^5,10

Liver health

Screening and Diagnosis

Back to MASLD/MASH

Resources

HOPE Resources

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Abbreviations

MASLD: metabolic dysfunction-associated steatotic liver disease; MASH: metabolic dysfunction-associated steatohepatitis; CRM: cardio-renal-metabolic; T2D: type 2 diabetes; CVD: cardiovascular disease; CKD: chronic kidney disease; HF: heart failure.

World Obesity Federation. World Obesity Atlas 2023. London: World Obesity Federation; 2023. Available from: https://www.worldobesityday.org/resources/entry/world-obesity-atlas-2023. Accessed May 2026.
Younossi ZM, et al. Global epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in 2019. Hepatol. 2023;77(4):1335–1347.
Fernando DH, et al. Development and progression of non‑alcoholic fatty liver disease: The role of advanced glycation end products. Int J Mol Sci. 2019;20(20):5037:1–18.
Quek J, et al. Global prevalence of non‑alcoholic fatty liver disease and non‑alcoholic steatohepatitis in the overweight and obese population: A meta‑analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20–30.
Office for Health Improvement and Disparities. Obesity profile: Short statistical commentary. London: UK Government; May 2025. Available from: https://www.gov.uk/government/statistics/obesity-profile-may-2025-update/obesity-profile-short-statistical-commentary-may-2025. Accessed May 2026.
World Obesity Federation. World Obesity Atlas 2024. 2024. Available at: https://data.worldobesity.org/publications/WOF-Obesity-Atlas-v7.pdf. Last accessed: May 2026.
Yanai H, et al. Metabolic-dysfunction-associated steatotic liver disease-its pathophysiology, association with atherosclerosis and cardiovascular disease, and treatments. Int J Mol Sci. 2023;24:15473.
Shrestha R, et al. BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study. BMJ Open. 2021;11:e050096.
Grant B, et al. Managing obesity in people with type 2 diabetes. Clin Med (Lond). 2021;21:e327-e331.
National Institute for Health and Care Excellence (NICE). Overweight and obesity management. NICE guideline NG246. London: NICE; 2025. Available from: https://www.nice.org.uk/guidance/ng246. Accessed May 2026.