Radiology’s Role in Evaluating and Treating Obesity

The following is a guest post by Drs. David M. Naeger, MD, and Aliya Qayyum, MBBS.

Obesity is a major problem in the United States and many other countries in the world. Most people don't think of radiology as being important in the medical evaluation and treatment of obesity—but it is!

Obesity is associated with a disease in the liver call NAFLD (nonalcoholic fatty liver disease): essentially, the liver gets infiltrated with fat and becomes inflamed. This can cause the liver to not function normally, possibly to the point of liver failure. Finding fat in the liver was previously accomplished with biopsy, which required putting a long needle through the skin and into the liver to take a sample. This is invasive and has other limitations. Today, radiologists can look for fat in the liver non-invasively. Ultrasound, CT, and MRI have all been used. Aliya Qayyum, a Professor of Radiology at UCSF is on the forefront of MR research in imaging this disease.

Interestingly, the "obesity" that is most associated with health problems—such as diabetes— is caused by the fat inside the belly, not outside. Therefore, a lot of obesity research involves measuring how much fat is inside the belly. Many radiology techniques have been developed for this purpose, most using CT or MRI.

One of the most dramatic treatments for obesity is bariatric surgery-- surgery that makes the stomach smaller or re-routes how food is digested. Before and after this surgery, radiology plays a key role in evaluating patients undergoing this procedure, including looking for complications.

Though radiology plays an important role in obesity, imaging larger patients can be difficult due to limitations of some scanners. UCSF, however, has some of the newest and best scanners, including those with the capability of imaging patients of all sizes.

To learn more about imaging of obesity, check out the article we recently published in Applied Radiology.