Non-alcoholic fatty liver disease (NAFLD): This condition is closely associated with obesity and can lead to low albumin levels due to impaired liver function. Elevated ALP can also be seen in NAFLD, especially if there is associated liver inflammation or fibrosis.

Alcoholic Liver Disease: Although the question does not specify alcohol use, it is a common cause of low albumin and elevated liver enzymes, including ALP, in obese patients who may consume alcohol.
NASH (Non-alcoholic Steatohepatitis): A more aggressive form of NAFLD, NASH can cause significant liver damage, leading to low albumin and elevated liver enzymes.
Cholestasis: Conditions causing cholestasis, such as primary biliary cholangitis or primary sclerosing cholangitis, can lead to elevated ALP. Low albumin can occur if the condition progresses to cirrhosis.

Budd-Chiari Syndrome: A rare condition caused by thrombosis of the hepatic veins, leading to liver dysfunction, which can present with low albumin and elevated ALP. It's crucial to consider this diagnosis due to its high mortality if left untreated.
Vitamin D Deficiency: While not directly causing low albumin, severe vitamin D deficiency can contribute to elevated ALP. In obese patients, vitamin D deficiency is common and can have significant health implications.
Malignancy: Certain cancers, such as pancreatic cancer, can cause obstructive jaundice leading to elevated ALP and low albumin due to malnutrition or liver metastasis.

Alpha-1 Antitrypsin Deficiency: A genetic disorder that can cause liver disease, leading to low albumin and elevated liver enzymes, including ALP.
Wilson's Disease: A rare genetic disorder causing copper accumulation in the liver, which can lead to liver dysfunction, low albumin, and elevated ALP.
Cystic Fibrosis: Although primarily a pulmonary disease, cystic fibrosis can also affect the liver, leading to focal biliary cirrhosis and potentially low albumin and elevated ALP.