Obesity important in NAFLD

Gastroenterologists need to acknowledge the importance of obesity in treating NAFLD, according to a panel discussion at the AGW annual conference last Friday. “When are we going to grow up and admit that it’s not ‘nonalcoholic’ it’s obesity driven, and that is the primary problem,” said Monash University’s John Dixon. “Obesity, and in particular central adiposity, drives a complex milieu of diseases. It’s not the liver disease that is going to kill our patients it is these diseases,” he said. Louise Baur, from the University of Sydney and the Children’s hospital at Westmead, agreed. She said that gastroenterologists often ignore thinking about dealing with a patients’ obesity when they present with conditions such as NAFLD because obesity is not their specialty. In addition, obesity is a difficult condition to treat because it is caused by a complex mix of local, national and international social factors as well as a patients choices, education and genetic make-up. Gastroenterologists, and other health professionals, need to move towards shared models of care that deal with obesity and not just its co-morbidities, she said. Geoffrey Farrell, from ANU, asked for a show of hands from the gastroenterologists who routinely take waist circumference measurements from their patients. He said that the vast majority of doctors who didn’t raise their hands should consider making such measurements a routine part of their practice, as waist circumference is a vitally important risk factor for a number of obesity and overweight-related conditions. He said that factors such as exercise are driven by patient choice and education, but research is also increasingly showing that genetic factors seem to increase the drive to eat large amounts of high-energy foods. “The drive to eat is very pernicious… and it’s in your genes,” he said....