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As obesity levels increase in children, the incidence of non-alcoholic steatohepatitis (NASH) and non-alcoholic fatty liver disease (NAFLD) also increases. Anecdotally, the current international guidelines for the management of children with this condition is starting to challenge the resources of liver clinics, purely because of the numbers of children referred and the number of investigations required. Bariatric surgery is also starting to be offered as a treatment option in this group, further increasing the demands on the service. Can bariatric surgery help in the long term? Stepping into the adult literature is always useful. Aminian A et al (JAMA 2021;326:2031–2042) have explored possible associations between …

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