The ability of the body to store energy in adipose tissue for utilization during exigency has helped us cope with periodic food shortages through much of human history. The easy availability of calorie-dense food and a sedentary lifestyle has, however, resulted in this becoming a bane with adverse health consequences. Both obesity and nonalcoholic fatty liver disease (NAFLD) are lifestyle diseases that have emerged as substantial public health problems globally and in India. Obesity is an important risk factor for NAFLD and its severe form of nonalcoholic steatohepatitis (NASH). Weight loss is the only proven beneficial intervention in NAFLD/NASH. This provides a unique opportunity for managing NASH in obese patients. Lifestyle interventions including dietary modifications and exercise should be the primary modality for weight loss and have shown to be feasible and effective in obese patients with NASH. Although not yet indicated for the management of NASH per se, anti-obesity drugs and bariatric procedures may be considered in selected patients if otherwise indicated and may lead to indirect hepatic benefits secondary to weight loss.