EditorialNo need for a large belly to have NASH

It has been recognized that some lean individuals unexpectedly present with non-alcoholic steatohepatitis (NASH) [1] and in contrast, morbidly obese individuals present NASH in only about 14-37% of cases [2]. Although this situation is seemingly paradoxical, the discrepancy has been mostly attributed to the pattern of obesity being predominantly visceral/truncal, or peripheral/subcutaneous. Obesity, and particularly visceral fat (VF), is considered a key player in the development of the metabolic syndrome and its complications, namely cardiovascular risk and non-alcoholic fatty liver disease (NAFLD). Indeed, waist circumference, considered an indirect measurement of VF, is one criterion in the metabolic syndrome definition.