Obesity is now a global pandemic, having huge economic burden and health costs because of its clinical consequences. Obesity is often associated with an increased incidence of type 2 diabetes, cardiovascular diseases, and the development of various malignancies. Obesity remains an independent risk factor for the development of hepatocellular carcinoma (HCC) and is also highly prevalent in patients with non-alcoholic fatty liver disease (NAFLD). 

NAFLD-related HCC is the most frequent indication for liver transplantation in many countries. The higher mortality rates among obese HCC patients may be due to a worse outcome after HCC treatments and also due to a delayed diagnosis associated with a low frequency and a punier quality of abdominal ultrasonography surveillance that is globally utilized for HCC screening. 

Obesity is frequently reported among patients with chronic liver diseases linked to different etiologies, which may further increase the HCC risk, serving as an added co-factor. 

A healthy diet and regular physical activity have shown the potential to reduce the overall HCC risk in recent studies. Emerging evidence indicates the role of obesity in the development of intrahepatic cholangiocarcinoma but further studies are warranted to confirm this association.

Source: Saitta C, Pollicino T, Raimondo G. Obesity and liver cancer, Annals of Hepatology,2019;18(6):810-815. https://doi.org/10.1016/j.aohep.2019.07.004.