If an individual is obese it is most likely that they suffer from non-alcoholic fatty liver disease or NAFLD.  There was a time when this condition was quite rare. Now it appears that more than half of Americans have it and more than a third of American children suffer from it.  The condition is generally a function of a diet rich in refined carbohydrates and the concomitant gut problems such as dysbiosis and bacterial overgrowth that feed off the sugar.