The number of overweight people who need a liver transplant has tripled in the last seven years, figures from Erasmus MC teaching hospital show.

The Rotterdam hospital, which is the main centre for the operation, carried out just a handful of liver transplants in 2017 but that number rose to 50 last year,

“Excess weight is often associated with heart disease and diabetes but it can also cause a fatty liver and that can ultimately lead to a liver transplant,’ surgeon Harry Janssen told broadcaster NOS.

The figures are worrying, said Mariël Croon, from abdominal health charity MDL. “A liver transplant is a last resort and not always possible because of long waiting lists,” she said.

According to the charity, some four million people in the Netherlands have a fatty liver, often without being aware of it. Some 700,000 have an active liver infection, which can lead to cirrhosis of the liver and liver cancer, necessitating a transplant. Alcohol use exacerbates liver damage.

The good news is that a lifestyle change can reverse damage to the liver relatively easily, Croon said. “If you get there in time the liver will heal itself. It’s a special organ and you need to look after it,” she said.

According to figures from public health organisation RIVM nearly two-thirds of Dutch will be overweight by 2050.