Metabolic dysfunction-associated steatotic liver disease
ICD-10 K76.0 · ICD-11 DB92

Treatment of MASLD with Overweight or Obesity

Clinical Scenario

This protocol addresses metabolic dysfunction-associated steatotic liver disease (MASLD) in patients who are overweight or obese — defined by a body mass index of ≥25 kg/m² in non-Asian individuals, or ≥23 kg/m² in people of Asian ethnicity.

BMI Thresholds by Ethnicity
Overweight
BMI 25–29.9 kg/m² (non-Asian)  |  23–24.9 kg/m² (Asian)
Obesity
BMI >30 kg/m² (non-Asian)  |  >25 kg/m² (Asian)
Treatment Approach

For eligible patients with non-cirrhotic MASLD in this BMI range, the protocol involves a surgical approach targeting durable, significant weight reduction. This intervention carries strong guideline support for beneficial effects on the liver.

Full regimen, eligibility criteria, and procedural details are in the structured protocol →
Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhep.2024.04.031

In adults with MASLD and overweight, dietary and behavioural therapy-induced weight loss should aim at a sustained reduction of >5% to reduce liver fat, 7–10% to improve liver inflammation, and >10% to improve fibrosis (LoE 2, strong recommendation, strong consensus).

Overweight: BMI of 25–29.9 kg/m² (non-Asian) or 23–24.9 (Asian). Obesity: >30 kg/m² (non-Asian), >25 kg/m² (Asian).

In adults with non-cirrhotic MASLD who have an approved indication, bariatric surgery should be considered, because it can induce long-term beneficial effects on the liver and is associated with remission of type 2 diabetes and improvement of cardiometabolic risk factors (LoE 3, strong recommendation, strong consensus).

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