OBESITY AND ADIPOSITY AS FACTORS ASSOCIATED WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE (MASLD): A NARRATIVE LITERATURE REVIEW

Abstract

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized in clinical practice and is strongly linked to obesity, visceral adiposity, insulin resistance and cardiometabolic risk. However, hepatic improvement may depend not only on weight loss but also on diet quality, body composition and metabolic changes. Objective: To narratively review the association between obesity/adiposity and MASLD, emphasizing related factors, clinical trial interventions and main hepatic and metabolic outcomes. Methods: A PubMed search was performed on July 29, 2026, using the strategy: ("Metabolic Dysfunction-Associated Steatotic Liver Disease" OR MASLD) AND ("Obesity" OR "Abdominal Obesity" OR Adiposity) AND ("Risk Factors" OR Association OR Prevalence). Clinical Trial, Randomized Controlled Trial and last 10 years filters were applied. After screening 60 records, 43 studies were included in the synthesis, with 35 as the main core and 8 as supporting studies. Results: The studies showed that reductions in body weight, waist circumference, visceral fat and insulin resistance were associated with improvements in liver fat, steatosis and metabolic markers. Dietary and lifestyle interventions were frequent, whereas incretin-based agents, metabolic modulators and selected nutraceuticals showed variable but clinically relevant findings in specific subgroups. Conclusion: Obesity and adiposity, especially visceral/abdominal adiposity, are central elements in MASLD. Management should prioritize sustainable weight loss, improvement in body composition, metabolic control and individualized treatment.