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Along with systemic inflammatory cues, perturbations in systemic and individual organ metabolic homeostasis result in metabolically driven cell stress, injury and death; this activates innate immune signals promoting fibrogenesis and organ dysfunction. The phenotype of end\u2010organ diseases is determined by the balance between metabo\u2010inflammatory signals and homeostatic restorative factors. Some of the key end\u2010organ diseases associated with obesity and metabo\u2010inflammation include atherosclerotic vascular disease, hypertension, type 2 diabetes mellitus, chronic kidney disease and heart failure with preserved ejection fraction. Metabolic dysfunction\u2010associated steatotic liver disease and steatohepatitis have recently been recognised as a part of a cluster of non\u2010communicable diseases that account for the majority of premature deaths worldwide. The epidemiology, biological relationships of obesity to MASLD, mechanistic relationships between MASLD and other non\u2010communicable diseases, and the clinical impact on patients are reviewed in this manuscript. We also include a basis for obesity\u2010oriented treatment to manage MASLD. In summary, we provide a rationale for a holistic approach to the care of individuals with MASLD with a focus on treating obesity as a root cause, while monitoring liver status to determine the need for additional liver\u2010targeted therapeutics.<\/jats:p>","DOI":"10.1111\/dom.70662","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:24:07Z","timestamp":1775017447000},"page":"3-18","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Current Trends in the Epidemiology of Obesity and the Association Between Obesity and Metabolic Liver Disease (MASLD\/MASH)"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2205-8093","authenticated-orcid":false,"given":"Mirjana","family":"Grocic","sequence":"first","affiliation":[{"name":"Department of Internal Medicine VCU School of Medicine  Richmond Virginia 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