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News
Newer, more complex obesity classifications don't outperform plain old BMI when it comes to predicting liver-related events in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A large multinational study found that while updated criteria from EASO and the Lancet Commission classify more people as obese, they offer no added value for liver risk stratification. For now, BMI remains the more practical tool.
When it comes to predicting liver trouble in MASLD patients, BMI holds its own. A large multinational study published in Hepatology evaluated whether newer obesity definitions — from the European Association for the Study of Obesity (EASO) and the Lancet Commission — could better predict liver-related events (LREs) compared to BMI alone. The findings were clear: they couldn't.
The study followed 12,583 MASLD patients across 16 sites in the US, Europe, and Asia. While the updated criteria classified significantly more patients as obese, patients who met EASO or Lancet obesity criteria but not BMI-defined obesity showed no meaningful increase in liver risk. BMI-defined obesity, on the other hand, was associated with roughly double the risk of LREs compared to normal weight.
Key Takeaways:
Why it matters: Clinicians may be tempted to adopt newer, more nuanced obesity classifications, but this study suggests that for MASLD liver risk assessment, BMI remains the most practical and predictive tool — keeping workflows simpler without sacrificing accuracy.
