How does being big affect my liver and what happens to my liver when I lose weight after surgery?
It turns out that fat is accumulated in the liver just like it is like under your skin, and that fat actually causes a condition of liver known as steatosis or fatty liver. About 96% of patients who meet the criteria for obesity actually have fatty livers, and that fat in the liver irritates the liver and causes inflammation of the liver. When inflammation has set in, we term that NASH or Nonalcoholic Steatohepatitis. That condition affects about 26% of people who have, who are big people.
Now, most of the time you don’t know that. What your primary care doctor will notice is just a little elevation in your liver functions. Now about nine percent of people will go on to develop actual cirrhosis of the liver, not caused by anything but having fat in the liver. So again, it’s another good reason to get your weight down.
When you’ve lost weight permanently and whether you’ve lost weight with a medical diet or surgery, when you have lost that weight, what happens is the fat comes out of your liver again. So if you are in the early stage where you just have steatosis or early NASH, then we think that resolves and your liver goes back to being a normal liver. But if you’ve already progressed to fibrosis, it probably stays the same; we hope that it doesn’t get worse.
Cirrhosis patients are in a whole different ballpark, and they need to be followed by a specialist.
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