Obesity and the Liver with Luc de Baerdemaeker

It’s back to Luc from Belgium to teach us about obesity and liver disease

Luc starts with a shocking case of non-alcoholic steatohepatitis in a young woman who underwent three transplants but sadly died due repeat NASH in the donor livers. The room collectively groans as the story unfolds.

“Not all fat is bad”. Luc introduces the concept that fat becomes dysfunctional and consequently triggers a complex inflammatory cascade leading to disease. Obese individuals are disproportionately deficient in vitamin D.

The combination of fructose with high fat content is irresistible to all animals. The consequence is clear. Luc stresses that the food industry know this and produce food and drink with exactly the optimal ratio of fructose and fat to encourage consumption! Depressing.

Given the link between obesity and the metabolic syndromes, should bariatric surgery be renamed “metabolic surgery”? Luc goes on to review surgical techniques and outcomes. Some centres are performing bariatric gastric reduction surgery at the same time as liver transplant! This is because recurrent NASH is becoming frequent, as in the case the Luc started his talk with.


  • More hepatic complications will occur due to increasing morbidity
  • NASH is an indication for liver transplant