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A 37 year old factory worker presents to his general practitioner for an occupational health assessment on the recommendation of his workplace. He complains of vague, intermittent discomfort in the upper right abdominal quadrant, with no other concerning features of systemic illness. He does not take any medications, does not smoke, drink alcohol, or take illicit drugs. He drinks three to four cans of cola and three to four cups of coffee daily. His height is 1.7 m, weight 82 kg, body mass index (BMI) 28.4 kg/m2, and waist circumference 110 cm. His blood pressure is 130/80 mmHg.