The Endocrinologist's View: Obesity, MASH, and the Metabolic Dysfunction That Connects Them

In this episode, 'The Endocrinologist's View: Obesity, MASH, and the Metabolic Dysfunction That Connects Them,' Jaime Almandoz, MD explores the following questions:

As an endocrinologist, how do you frame obesity and MASH within the broader context of metabolic disease? Why is insulin resistance such a central thread connecting them?

How prevalent is MASH among your endocrinology patient population, and is it something you are actively screening for or more likely to encounter incidentally?

What metabolic profiles beyond obesity raise your suspicions for underlying MASH?

Almandoz framed obesity, type 2 diabetes, cardiovascular disease, and MASH not as separate conditions but as different manifestations of the same underlying metabolic dysfunction, making MASH not merely a liver problem but a signal of broader cardiometabolic burden that demands comprehensive attention. He also highlighted the striking prevalence of MASH in his endocrinology patient population, noting that approximately three out of four patients with obesity have MASLD and one in three have MASH, while roughly two thirds of patients with type 2 diabetes have MASLD and approximately a third have MASH. Given these rates, Almandoz emphasized that MASH should not be treated as a rare complication but as a condition clinicians should be actively screening for in any patient presenting with obesity or type 2 diabetes rather than waiting for incidental discovery.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'From Siloed to Synchronized: Building the Multidisciplinary Care Model That MASH Patients Need,' features Jaime Almandoz advancing his conversation on obesity and MASH and focusing on whether the field has been too siloed in its approach to managing metabolic dysfunction across obesity, diabetes, and liver disease, what a truly integrated multidisciplinary care model should look like.