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Surfing the NASH Tsunami hosts its first episode dedicated to nutrition and NASH with distinguished guest, Prof. Shira Zelber-Sagi. Surfing alongside are Ken Cusi, Jörn Schattenberg, Louise Campbell and Roger Green to discuss weight reduction for NASH resolution, and strategies for long-term adherence to lifestyle modifications.

Shira leads this conversation by introducing the topic of weight reduction as a first line of defense for the field of NAFLD. While discussing weight loss targets for patients with different degrees of Fatty Liver disease, it’s identified that ≥7% weight reduction is a “golden number” for patient resolution. In terms of how weight reduction is achieved and maintained, it is noted that long-term adherence to lifestyle modification poses significant challenges. Choosing the right diet for a diverse population of patients can be daunting. Before disclosing her own ideas, Shira asks for the group’s approach to the topic. Jörn suggests hepatologists are not particularly effective at assessing diets or prescribing specific solutions. As such, he adheres to simple protocols like intermittent fasting. Jörn also asks a question to the group that he receives often: Why is there a need for drugs in this disease if patients just need to lose weight? Ken notes that in the US, excess caloric intake can be treated with the prescription of weight-loss medications, like a GLP-1, or more NASH-specific agents, like pioglitazone. He also suggests endocrinologists are better equipped to provide education on nutrition to patients. The group agrees that partnering with a nutritionist is invaluable for developing strategies around long-term self-management. Finally, Louise shares her belief that successful solutions begin with small, achievable goals.