But you've probably never heard of Non-Alcoholic Fatty Liver Disease.
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It is now a prime reason for liver transplants in America.
"The liver is a remarkable organ," quips Temple Health bariatric surgeon Rohit Soans.
In fact, the liver makes clotting factors for the blood, sugar, fat, and it processes drugs.
However, up to one in three Americans has a problem called NAFLD - Non-Alcoholic Fatty Liver Disease.
It often occurs alongside metabolic syndrome....
"Patients with obesity, patients with hypertension, patients with type 2 diabetes, patients with high lipids - high cholesterol," says Dr. Lee Peng, a liver specialist at Temple Health.
Dr. Peng says fat buildup can cause inflammation.
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"That can lead to scarring of the liver and what we call fibrosis of the liver," he notes, adding, "If the inflammation and scarring is long-standing, severe, that can lead to permanent liver damage."
Driven by the obesity epidemic, fatty liver is quickly becoming a common reason for liver transplants.
Dr. Peng says the condition seldom causes symptoms, isn't generally found on yearly checkups, and -
"Unfortunately, there's no FDA-approved medications for treatment of non-alcoholic fatty liver disease," he says. "We rely a lot on lifestyle changes."
So patients are encouraged to lose weight with exercise and a healthy diet.
And many are referred to bariatric surgeon Dr. Soans.
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He says patients seldom realize the dangers of excess weight to the liver - or the difference bariatric surgery can make.
"When you start losing weight, one of the first places where you'll lose the weight will be your liver," says Dr. Soans.
And shrinking the liver by weight loss before an operation helps in another way.
"That left lobe of the liver sits right over the stomach. When it becomes smaller, our patients can have a safer, more effective surgery, because our visualization as surgeons is much, much better," adds Dr. Soans.
Treating obesity before cirrhosis develops is essential to reversing fatty liver disease.
"The older patients, I would say, who have had obesity for a longer period of time, may be suffering from some of the worst kind of outcomes in terms of liver issues," remarks Dr. Soans.