As if there weren’t already enough complications from the obesity epidemic. Now research shows some overweight teenagers have severe liver damage caused by too much body fat, and some have even needed liver transplants.

The American Liver Foundation estimates two- to five-percent of American children over age five – nearly all of them obese or overweight – have what’s known as nonalcoholic fatty liver disease. The condition can lead to cirrhosis and liver failure or liver cancer and is now in kids in the United States, Europe, Australia and even some developing countries, says The Associated Press.

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