Management of obesity in advanced chronic liver disease

Obesity has emerged as a major global health challenge and is closely associated with metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction- and alcohol-associated liver disease (MetALD). Overall, an increased prevalence of obesity has been reported in patients with advanced chronic liver disease (ACLD), in whom it adversely impacts prognosis. Importantly, increased BMI is recognised as a modifiable risk factor for progression of liver disease, regardless of aetiology. The recent approval of effective and well-tolerated anti-obesity medications offers new opportunities, alongside therapeutic lifestyle changes and bariatric surgery, for the personalised management of patients living with obesity and associated liver disease.