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Since its early editions, the seminal textbook on liver and biliary diseases edited by the late Dame Sheila Sherlock has taught countless hepatologists that the most common histologic picture associated with an elevation of liver enzymes discovered at routine screening is steatosis. Excluding alcohol-related steatosis and chronic hepatitis C, fatty liver disease is still the most common liver disease in the United States, with a prevalence of about 5 percent in the general population. This figure soars to more than 90 percent among persons with obesity, diabetes, or hyperlipidemia. Given the increasing prevalence of obesity in young people, the incidence
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