Obesity and Fatty Liver Disease

Beccy Cooper Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Beccy Cooper (Worthing West) (Lab)]

I beg to move,

That this House has considered obesity and fatty liver disease.

It is a pleasure to serve under your chairship, Mr Efford, alongside my parliamentary colleagues who have kindly come along this morning to debate and highlight the public health emergency that is obesity and fatty liver disease.

The vast majority of us do not often think about the health of our livers. If we do, our biggest concern is how many units of alcohol we drink every week and whether our livers can keep up. But we do talk about our weight a fair amount, either in terms of how we look and how our clothes fit, or, if we are linking it to disease, whether we are blocking up our arteries and risking a heart attack. Today I want to make the case for linking our concerns about being overweight and sedentary with the very real risk of developing fatty liver disease. Before I give the alarming statistics about the huge increase in liver disease in the UK, I want us all to hold on to the fact that a weight loss of 10% can halt and even reverse fatty liver disease progression, and the way to help us all to do that is not to point fingers and tell individuals to try harder. There are much more effective public health solutions than that.

Now for the alarming statistics that should give us all pause for thought: after heart disease, liver disease is the biggest cause of premature mortality and lost working years of life in the UK. In stark contrast with other killer diseases where the mortality rate has gone down, deaths from liver disease have increased by 400%—yes, 400%—over the past two decades. Every year we are seeing 18,000 deaths from liver disease. It is now the biggest killer of 35 to 49-year-olds in the UK. In two to three years it is set to surpass heart disease as the leading cause of premature death in the UK.

Today’s debate matters because fatty liver disease is becoming one of the defining public health challenges of our generation—a disease that already affects as many as one in five adults in the UK, equating to about 1 million people, but one that hardly anyone knows about. When I asked my parliamentary colleagues to speak in today’s debate, they said, “Fatty liver disease? What’s that?” So hopefully this debate will highlight this alarming disease.

Closely linked to our ongoing struggles with obesity, fatty liver disease—for the record, its clinical name is metabolic dysfunction-associated steatotic liver disease; that is the last time I am going to say that today—is deeply rooted in our broken food systems and the stark health inequalities that our communities face.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Lady on securing the debate. She is outlining very clearly the importance of the issue. It is vital that people are aware of it. Does she agree that if we do not deal with the issue, the NHS waiting lists over the coming years will be compounded even further than they have been already?

[Dr Cooper]

I thank the hon. Member for making that excellent point. He is absolutely right. The issues of the NHS waiting lists are pertinent and stark. Reducing them will mean that we have to get the left shift right as well as invest in acute services.

Our policies have failed the population for decades. This debate is an opportunity to make the urgent case for a national liver strategy, joined-up public health work and profound reform of the conditions that stop us all living well. Because we have failed to build an environment where healthy food is affordable and accessible, two thirds of UK adults are now overweight or obese, and one in three children in England are above a healthy weight when they leave primary school.

Fatty liver disease is a silent killer, often asymptomatic until at a very advanced stage, meaning many patients are diagnosed too late for effective intervention. Left untreated, as too many are, fatty liver disease can progress to liver inflammation, fibrosis, cirrhosis, liver failure or liver cancer. Fatty liver disease also increases significantly the risk of heart attacks, stroke and heart failure. It is projected to overtake alcohol as the leading cause of liver transplants within a decade.

How do we treat fatty liver disease? Despite high and rising mortality rates, there are limited treatment options for patients with this disease. As I have said, weight loss and lifestyle change are essential.

[Clive Jones (Wokingham) (LD)]

I thank the hon. Member for bringing this very important subject to Westminster Hall. She is absolutely right. Fatty liver disease is the fastest rising cause of liver cancer death in the UK and highlights the risk of developing a less survivable cancer for people living with obesity. Does the hon. Member agree that improvements to diagnosis of and treatment for fatty liver disease should be covered in the national cancer plan, which I called for a year ago and the Government are to announce early next year?

[Dr Cooper]

I thank the hon. Member for his excellent intervention. I absolutely agree that the national cancer strategy is essential. We must make sure that liver cancer is integrated into it, and that diagnosis and treatment are a key part of it and are funded across the country, to make sure that the inequalities that I am going to talk about are addressed sufficiently.

Before we get to the issue of diagnosis and treatment, weight loss and lifestyle change are essential. We know that a Mediterranean diet plus exercise improves liver function and that reducing ultra-processed foods reduces intrahepatic fat. However, for those whose disease has progressed to scarring of the liver, or liver fibrosis, there is an urgent need for therapies that directly target the liver.

Currently, no drugs are licensed to treat fatty liver disease in the UK. We have fallen behind the United States and Europe, as our market is too small for prioritisation. If I might get a bit more political, that is driven in part by our decision to leave the European single market. But this is a rapidly advancing field and we are approaching a potential breakthrough in treatment. With adequate planning, co-ordinated action, investment and leadership, we can ensure that our national health system is patient-ready to deliver the next generation of medications, and that all patients, regardless of postcode, can benefit.

Early diagnosis offers significantly better outcomes and a wider range of treatment options, but despite fatty liver disease being medically recognised in the 1980s, clinical and public awareness of it remains far too low. We urgently need to increase public understanding and encourage early liver checks, particularly for those at higher risk because of obesity or type 2 diabetes. What is more, we have seen primary care systemic failures to improve early detection, such that three quarters of people are diagnosed with cirrhosis at hospital in an emergency, when it is too late for effective treatment or intervention.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I, too, congratulate my hon. Friend on an excellent and really important debate. May I take her back to what she was saying about the food industry, wider population prevention measures and what this means for school meals and for our poorer communities, who are reliant on food supporters, such as the Trussell Trust and others, in terms of the type of food made available to them?

[Dr Cooper]

I thank my hon. Friend for that excellent intervention. She is absolutely right. With her public health expertise, she highlights the very real problems that lead to fatty liver disease: our broken food system, the issue with access to good, nutritious food for children in school, and the need to ensure that our stark health inequalities are addressed. I will come to that later in my speech.

To go back to the issue of diagnosis and treatment, we should note that a staggering 80% of England currently has no effective detection and treatment pathway—yes, a staggering 80%. The British Liver Trust, whose representatives are here today, is rightly calling for an end to this postcode lottery, so a key ask raised in this debate is that every integrated care board, every regional and national health area that we have, should have a full pathway for early detection of liver disease.

There is some excellent, innovative work out there that can help us to get to a much better place in tackling this disease. I recently met the team at Predictive Health Intelligence—whose representatives I think are also here today—who have developed hepatoSIGHT, which is a great name; well done. That is an inspiring example of how technology can transform early detection. The system uses existing NHS data to identify people at risk of liver disease before symptoms develop, allowing GPs proactively to invite patients for screening and support. I am delighted to say it is now being implemented across NHS South West. It is proof that, with genuine support from senior NHS management, clinical and digital teams at all levels can come together for the good of patients. That system is exactly the kind of innovation we need in order to make early diagnosis and prevention the norm and not the exception.

I now come to prevention. Screening and early diagnosis are vital but, as for all population health issues, as my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) rightly highlighted, we must have a laser focus on preventing the root causes of fatty liver disease.

[Steve Yemm (Mansfield) (Lab)]

I thank my hon. Friend for raising this debate. We are calling obesity the enemy, but the liver does not count in pounds or kilograms. The real culprit is not body weight; it is metabolic dysfunction, as she points out—insulin resistance, poor diet, genetic risk and so forth. Lean people also get fatty liver disease, not always people who are overweight. Does my hon. Friend agree that we should talk less about obesity and more about screening early, taxing junk food and treating metabolic disorders and disease rather than strictly BMI? If we chase the scales, we might miss the science.

[Dr Cooper]

I thank my hon. Friend for that excellent point and agree absolutely. In our society, we focus on how people look for many reasons, cultural and commercial, but this is purely about health. This is about keeping people healthy on the inside and allowing them to live good quality lives. My hon. Friend is absolutely right in that sense.

Poor diet is now the leading risk factor for death and disability. It is responsible for millions of preventable deaths each year. In the UK, almost two thirds of adults are overweight or are living with obesity, increasing the risk of fatty liver disease, cardiovascular disease and a multitude of cancers. In my job as a public health consultant, I see a lot of data and read many papers, but this statistic shocked me: four in 10 children with obesity may already have fatty liver disease. That demonstrates the urgent need to act now to prevent an even greater epidemic of disease in future.

That has not happened by accident; it is the result of a broken food system, which has made the UK Europe’s third most obese country and one of the world’s biggest consumers of ultra-processed food. We have a system that makes the unhealthy choice the cheapest, easiest and most available choice. Healthier food now costs more than twice as much per calorie as unhealthy food. That is £10.24 per 1,000 kilocalories compared with £4.50. For fruit and vegetables, the cost is even more at £11.90 per 1,000 kilocalories.

For the lowest income households, following a recommended healthy diet would swallow half or more of their disposable income. It is no surprise that obesity and fatty liver disease hit hardest in poorer communities. As I said at the beginning, this is not about personal failure. As hon. Members have said, sometimes people feel that that they are failing to lose weight and failing to keep themselves healthy. This is not about personal failure; it is a political failure. It is our collective failure to create a food environment that protects rather than undermines public health. If we are serious about prevention, we must be serious about reform—the right type—with stronger fiscal and regulatory measures to reduce the availability and marketing of foods that are high in fat, salt and sugar, and to rebuild a food system that serves public health and not profit.

Why have we not addressed this yet? Weighted against the commercial gain of the food and drink industry, our obesogenic environment is killing our population and costing the taxpayer billions. Economic analysis last year suggests that excess weight costs the economy £126 billion a year. A Budget is coming up next month; I am fairly sure that our Chancellor would like £126 billion a year. That figure takes in wider factors, such as lost productivity, care costs and lost years of healthy life. The direct NHS cost of obesity is projected to rise from £6.5 billion to £9.7 billion by 2050. We cannot separate our health and our wealth, and we cannot hope to achieve economic growth without tackling issues such as obesity and fatty liver disease.

Since 1990, there have been nearly 700 policies proposed by Government to reduce obesity. Imagine having 700 policies about your life! Past strategies fell short because they targeted behaviour change—individual choice—rather than the structural and commercial drivers of diet. Many lacked delivery plans, timelines or evaluation frameworks, leading to fragmented progress and limited long-term impact.

What can we do now to ensure that this public health emergency is addressed? My key asks for our Health Minister, who is kindly listening here today, are as follows. First, there is a clear need for a national liver strategy, ensuring increased public awareness, early liver checks and primary care pathways. As stated earlier, every integrated care board should have a pathway for the early detection of liver disease.

Secondly, we need strong planning and co-ordination to be ready to deliver the next generation of medication for liver disease. Thirdly, if we truly mean to deliver the left shift to prevention, promised in the 10-year health plan for England, then we have to change the environment that is driving poor health. There is strong consensus about the necessity of upstream interventions to regulate the unhealthy food and drink environment. We can build on that strong consensus to extend the levy model to high-sugar and high-salt foods; to enforce the 9 pm watershed for high fat, salt and sugar advertising, closing brand mark loopholes; to provide stable funding for local food partnerships, so that councils can act on local needs; to reinstate the full childhood obesity plan; and to address food affordability via fiscal reform.

None of this is easy or it would have been done already, but right now our environment is draining our health service of billions each year and weighing heavily on the nation’s health—no pun intended. Let us not keep repeating our mistakes, but rather embed food policy as a national health priority. Through our work on preventing obesity and fatty liver disease, let us support and finally see the long-discussed and essential shift towards prevention and a healthier, wealthier country.

[Clive Efford (in the Chair)]

I remind Members to bob in their places if they intend to speak.

--- Later in debate ---

[Dr Cooper]

Thank you, Mr Efford, for chairing the debate this morning. I thank the Minister for her excellent remarks, and all the parliamentary colleagues who have taken the time to be here. I thank the British Liver Trust and everybody who came to hear the debate. I hope they found it edifying and useful.

I have no particular further remarks; I think most points have been covered. There is a lot of work to do. As has been said, 90% of liver disease is preventable. That is a serious amount of disease that we do not need to face in this country, which is incredibly important to remember.

Our obesogenic environment—my hon. Friend the Member for Chelsea and Fulham (Ben Coleman) told me to say that slowly; it basically means it is hard for us to do healthy things and keep well—encourages us, consciously and subconsciously, to do things that are not great for our bodies. The Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), said that we have agency. Of course we do, but we are humans in an environment that is telling us all sorts of things all the time. Our job as parliamentarians, as representatives of our residents, as members of the party that is governing the country, is to make sure that the messages and signals that we send, and the legislation that we pass, encourage a healthy environment for our residents to live in. Within that healthy environment, people can make their own choices.

To those who accuse me and other public health consultants of being part of a nanny state, I say, frankly, the nanny we have in this state right now is not a great nanny. It is one that allows us to eat things that make us ill, that encourages us to not exercise, that makes our children sick and that means we die earlier than we need to. I do not want to live in a nanny state, but I do want to live in a healthy environment that allows our children to live well and allows all of us to live the lives that we want to lead—one that makes the healthy choice the easy choice, the affordable choice and the normal choice, and one where, if we want to do things that make us ill, we really have to try hard. I thank everybody for their time today.

Question put and agreed to.

Resolved,

That this House has considered obesity and fatty liver disease.