Current Trends and Perspectives on Obesity and Metabolic Dysfunction-Associated Steatohepatitis in East Asia

Obesity is a global epidemic that has rapidly increased in prevalence in East Asian countries. Complications of obesity, such as metabolic dysfunction-associated steatohepatitis (MASH), have increased in parallel with the recent rise in obesity. Rapidly aging populations, increasingly Westernized lifestyles, and a likelihood of developing higher-risk fat types (e.g., visceral adipose tissue) all play a role in the rising influence of obesity and MASH in East Asian populations. Additionally, East Asian patients are at high risk for developing lean MASH at lower body mass indexes than are common in Western populations. Tools to specifically detect and diagnose MASH in East Asia are lacking. Non-invasive tests (NITs) used globally to detect MASH have inadequate evidence of efficacy in East Asian populations. Current treatment strategies are also inadequate, with East Asian patients largely underrepresented in obesity and MASH clinical trials. Given large, diverse healthcare systems and a lack of awareness and infrastructure to support prevention and long-term management, obesity and MASH are rapidly becoming serious public health concerns in these countries. Therefore, both patients and physicians need better awareness of obesity and MASH, improved access to NITs to diagnose MASH, and more effective treatment options than they currently have. Educational methods should be developed to improve awareness, and more clinical studies of NITs and treatments in East Asian populations are needed.