Abstract
This prospective study was carried out in order to evaluate the influence on liver morphology and function of a very-low-calorie formula diet. Fourty-one morbidly obese, non-alcoholic subjects had liver biopsy performed before and after a median weight loss of 34 kg. Fatty change improved ( p < 0.001), but 24% of the patients developed slight portal inflammation ( p = 0.039) or slight portal fibrosis ( p = 0.063). Patients developing portal fibrosis had a higher degree of fatty change at entry ( p = 0.029), a more pronounced reduction of fatty change ( p = 0.014) and a faster weight loss ( p = 0.026). Liver biochemistry, which was of no individual diagnostic value, improved. It is concluded that morbidly obese subjects with a high degree of hepatic fatty change are at risk of developing portal inflammation and fibrosis when undergoing very fast dietary weight reductions.
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