Intended for healthcare professionals

Practice ABC of obesity

Obesity—time to wake up

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:640

Obesity – time to wake up to NAFLD

Haslam et al. make an excellent introduction into the series
regarding the consequences of obesity. Nevertheless, they do not mention
an important associated condition that deserves greater recognition: non-
alcoholic fatty liver disease (NAFLD).

Both body mass index and waist circumference have been shown to be
associated with NAFLD prevalence.(1) It is surprisingly common, occurring
in between 16-30% of unselected populations, and appears to be rising.(2)
Although closely related to the metabolic syndrome (previous investigators
have suggested a NAFLD prevalence of 72.5%), the two are not mutually
inclusive.(3) Furthermore, there is wide variation in diagnosis and

As with obesity, NAFLD is a challenge for primary and secondary care
throughout the world: increased education and awareness is paramount.

1. Church TS, Kuk JL, Ross R, et al. Association of cardiorespiratory
fitness, body mass index, and waist circumference to nonalcoholic fatty
liver disease. Gastroenterology. 2006 Jun;130(7):2023-30.

2. Angulo P. Non-alcoholic fatty liver disease. N Engl J Med 2002;

3. Sorrentino et al. Silent non-alcoholic fatty liver disease – a clinical
histological study. J Hepatol 2004;41:751-7

4. Riley MR, Bass NM, Rosenthal P, Merriman RB. Underdiagnosis of
pediatric obesity and underscreening for fatty liver disease and metabolic
syndrome by pediatricians and pediatric subspecialists. J Pediatr. 2005

Competing interests:
None declared

Competing interests: No competing interests

26 September 2006
Nij Bhala
Specialist Registrar in Gastroenterology, Hepatology and General Medicine
Department of Gastroenterology, University Hospital of Coventry & Warwick, Walsgrave, CV2 2DX, UK