Weight loss in overweight patients with NAFLD/NASH is an important therapy. Most guidelines and reviews on the treatment of NAFLD warn against rapid, drastic weight loss, as this could worsen liver function. However, I have not yet found any literature, neither study results nor case studies documenting such a complication. Does anyone know such literature?
Thank you!
I have read this journal title Aggressive non-alcoholic steatohepatitis following rapid weight loss and/or malnutrition. (written by Tsai JH et.al.) The mechanism of liver injury in aggressive steatohepatitis is unknown, but rapid fat mobilization in obese patients may potentially cause oxidative stress to the liver. Even though this mechanism is still controversial.
There is one article which reported cases of severe NASH after rapid weight loss or malnutrition. The article described 6 patients who developed severe hepatic dysfunction following rapid weight loss or malnutrition . Rapid weight loss (18 to 91 kg) occurred after Roux-en-Y gastric bypass in four patients and starvation-like dieting or hypoalbuminemia was noted in two patients. Four patients either died or received an urgent liver transplant.
Pathologic findings were characterized by advanced alcoholic steatohepatitis-like features, including extensive/circumferential centrizonal pericellular fibrosis, central scar with perivenular sclerosis/veno-occlusion with superimposed hepatocellular dropout, abundant/prominent hepatocellular balloons, and numerous Mallory–Denk bodies, but there was no history of excess alcohol consumption .
doi: 10.1038/modpathol.2017.13
Rapad loss of weight is not recommended also for people without NASH índex