Changes in hepatic morphology were evaluated in 242 consecutive liver biopsy specimens obtained from nonalcoholic obese subjects. Steatosis occurred in 59.7% of the subjects but was moderate to severe in 28.7%. An alcoholic hepatitis-like picture was present in 8.7% and cirrhosis in 2.7%. Fibrosis of mild and moderate degrees was encountered in 26.1% and 5.8%, respectively. This study indicates that the histopathological changes that occur in the livers of obese subjects are similar to alcoholic liver injury.

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Though obesity, alcohol abuse and jejunoileostomy are often a dangerous combination, exceptions do exist. This paper reports on the long-term outcome of 12 patients who had hepatic cirrhosis prior to jejunoileostomy. The six patients who refrained from or significantly restricted alcohol intake following jejunoileostomy all survived a minimum of 2 years following surgery. Four of these patients, now 6 to 25 years post surgery, are still living as of August 1993.

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