Non-Alcoholic Steatohepatitis (NASH) is a more advanced and aggressive form of fatty liver disease characterized by liver inflammation and cellular injury in addition to fat accumulation. NASH represents a critical stage in the spectrum of non-alcoholic fatty liver disease and carries a higher risk of progression to fibrosis, cirrhosis, and liver cancer.

Obesity is a primary driver of NASH. Excess visceral fat promotes chronic inflammation, insulin resistance, and lipid overload in the liver. These factors lead to ongoing liver injury and scarring over time. Unlike simple fatty liver, NASH is a progressive disease that can cause significant liver damage even in the absence of symptoms.

Patients with NASH may experience fatigue, right upper abdominal discomfort, or no symptoms at all. Diagnosis often requires blood tests, imaging, and sometimes liver biopsy to assess inflammation and fibrosis. Without intervention, NASH can silently progress to end-stage liver disease.

Bariatric surgery has emerged as one of the most effective treatments for obesity-related NASH. Surgical weight loss reduces liver fat, suppresses inflammatory pathways, and improves insulin sensitivity. Clinical studies show significant regression of liver inflammation and fibrosis following sustained weight loss after bariatric procedures. Importantly, bariatric surgery addresses multiple drivers of NASH simultaneously obesity, diabetes, dyslipidemia, and metabolic syndrome making it a comprehensive therapeutic approach. Early surgical intervention can halt disease progression and significantly reduce the risk of cirrhosis and liver-related complications.

Careful patient selection and pre-operative evaluation are essential, particularly in patients with advanced liver disease. Post-operative follow-up focuses on nutrition, weight maintenance, and liver function monitoring. By intervening before irreversible damage occurs, bariatric surgery offers patients with NASH a powerful opportunity to restore liver health and prevent long-term complications.