A significant global health concern, obesity affects millions of people worldwide. Although it can be related to several metabolic conditions, including diabetes and cardiovascular diseases, the connection to liver cancer gets less recognition. Obesity is a significant risk factor for several kinds of cancers, including liver cancer. The link between obesity and liver cancer is primarily caused by a few interconnected mechanisms that increase the risk of getting this harmful disease as shared by Dr Rahul Wagh, Consultant Surgical Oncology, Manipal Hospital, Pune.


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Obesity is defined as having an excessive amount of body fat, typically measured using a Body Mass Index (BMI) of 30 or higher. Obesity is caused by an energy imbalance between calories consumed and calories expended, which is often exacerbated by unhealthy eating habits and a sedentary lifestyle.


Risk factors: 


Non-alcoholic Fatty Liver Disease (NAFLD): NAFLD is a condition that is associated with fat buildup in the liver and can be brought on by obesity. Non-alcoholic steatohepatitis (NASH), which involves inflammation and damage to liver cells, can develop from this illness. The most prevalent kind of liver cancer, hepatocellular carcinoma (HCC), and liver cirrhosis are both made more likely by NASH.


Type 2 Diabetes and Insulin Resistance: Obesity frequently results in these conditions, which are risk factors for liver cancer. Elevated insulin-like growth factor (IGF) and hyperinsulinemia (high insulin levels) can prevent apoptosis (programmed cell death) and encourage the proliferation of liver cells, which can lead to the development of cancer.


Chronic Inflammation: Obesity is linked to chronic low-grade inflammation, which over time can lead to liver damage and inflammation. Liver cancer can grow in this chronically inflamed state because of the favorable conditions it creates.


Hormonal Changes: Being obese has an impact on hormone levels, which include elevated levels of adipokines (hormones made by fat tissue) and estrogen. These hormonal alterations can affect the risk of cancer by suppressing apoptosis and encouraging the proliferation of liver cells.


Oxidative Stress: Being obese can raise the level of oxidative stress, which damages liver cells and increases the growth of cancer. The body's imbalance between antioxidants and free radicals can harm DNA and liver cells, raising the risk of cancer.


Prevention


1. Weight Management:
   - Maintaining a healthy weight through a balanced diet and regular physical activity can reduce the risk of obesity-related liver cancer.
   - Weight loss in obese individuals can decrease liver fat, and inflammation, and improve insulin sensitivity.


2. Healthy Diet:
   - A diet rich in fruits, vegetables, whole grains, and lean proteins can help prevent obesity.
   - Reducing the intake of processed foods, sugary beverages, and high-fat foods can lower the risk of obesity and associated liver conditions.


3. Regular Exercise:
   - Engaging in regular physical activity helps maintain a healthy weight and reduces the risk of developing NAFLD and type 2 diabetes.


4. Screening and Monitoring:
   - Individuals with obesity, NAFLD, or type 2 diabetes should undergo regular liver function tests and screenings for early detection of liver abnormalities.
   - Early intervention can prevent the progression to liver cancer.


5. Management of Comorbid Conditions:
   - Proper management of conditions like type 2 diabetes, hypertension, and hyperlipidemia is crucial to reduce liver cancer risk.
   - Medications and lifestyle modifications can help control these conditions.


6. Avoidance of Alcohol and Toxins:
   - Limiting alcohol intake and avoiding exposure to known liver toxins can further reduce the risk of liver damage and cancer.