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significant or rapid elevation warrants investigation For patients with known or suspected fatty liver disease, a FIB-4 score (calculated from ALT, AST, age, and platelet count) can help stratify fibrosis risk non-invasively If gallstone risk is elevated particularly in rapid responders with significant early weight loss discuss whether ultrasound surveillance or ursodeoxycholic acid prophylaxis is appropriate Ask: "Do you have any concern about my liver function specifically, and should we track gallstone risk given how quickly I'm losing weight?" Question 8: Are There Any Vitamin or Nutrient Deficiencies I Should Watch For