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Medically reviewed by William Wadzinski | MD, Uniformed Services University of the Health Sciences on October 9th, 2023.
Two main types exist: alcoholic (from heavy drinking) and non-alcoholic (NAFLD), with NAFLD affecting 25% of the global population and closely linked to metabolic syndrome.
Most people show no symptoms initially, but when present, fatigue and dull upper-right abdominal pain are most common—blood tests revealing elevated ALT and AST enzymes often provide the first clues.
Losing 7-10% of body weight can significantly reduce liver fat, with studies showing a 5% weight loss improves insulin resistance while 10% can reverse liver fibrosis.
The Mediterranean diet with reduced refined carbohydrates proves most effective, as excess sugar converts to fat in the liver more readily than dietary fat itself.
Without intervention, 20% of cases progress to non-alcoholic steatohepatitis (NASH), which can advance to cirrhosis within 10-15 years, making early detection crucial.
Fatty liver disease is a common condition where extra fat builds up in your liver. It often causes no symptoms and can be reversed with diet and exercise. However, if left untreated, it can lead to more serious liver problems.
There are two main types of fatty liver disease:
Nonalcoholic fatty liver disease (NAFLD): This type affects 1 in 3 adults in the U.S. and is not caused by drinking alcohol. There are two forms of NAFLD:
Simple fatty liver: Fat builds up in the liver but usually doesn't cause liver damage or problems.
Nonalcoholic steatohepatitis (NASH): A more serious form that causes liver inflammation and damage, and can lead to scarring, liver cancer, and liver failure.
Alcohol-related fatty liver disease (ALD): This less common type is caused by drinking too much alcohol, which can lead to an enlarged liver, alcoholic hepatitis, and cirrhosis (liver scarring).
Most people with fatty liver disease have no symptoms. Some may experience:
Tiredness
Pain in the upper right side of the abdomen
Enlarged liver
Swollen belly
Jaundice (yellowing of the skin and eyes)
Factors that increase your risk of NAFLD and NASH include:
Obesity or being overweight
Type 2 diabetes or insulin resistance
High cholesterol or triglycerides
Metabolic syndrome
Being Hispanic or Asian
For ALD, the main risk factor is drinking too much alcohol, especially if you are obese, malnourished, or have hepatitis C.
To diagnose fatty liver disease, your doctor may use:
Physical exam to check for an enlarged liver or other signs
Blood tests to assess liver function and damage, rule out other causes, and estimate liver scarring
Imaging tests like ultrasound, CT scan, or MRI to look for fat in the liver
Liver biopsy to confirm NASH and check for inflammation and scarring
Treatment for fatty liver disease focuses on reversing the condition and preventing liver damage through lifestyle changes such as:
Losing weight gradually if you are overweight or obese
Following a healthy plant-based diet low in saturated fats and added sugars
Exercising regularly
Avoiding alcohol
Managing conditions like diabetes and high cholesterol
Taking vitamin E supplements (for NASH)
In severe cases of NASH with cirrhosis or liver failure, a liver transplant may be necessary. Learn more about NAFLD and NASH, ALD, and liver transplantation.
You can reduce your risk of fatty liver disease by:
Maintaining a healthy weight
Eating a nutritious diet high in fruits, vegetables, and whole grains
Exercising most days of the week
Limiting alcohol intake
Getting vaccinated against hepatitis B and C
With the right diagnosis, treatment, and prevention strategies, fatty liver disease can be managed and even reversed. Talk to your doctor if you think you may be at risk or have symptoms of fatty liver disease.
The condition is largely reversible through sustained weight loss and dietary changes, particularly reducing sugar and processed foods while increasing physical activity. Early detection and intervention prevent progression to serious liver damage that affects one in five untreated cases. If you're experiencing unexplained fatigue or abdominal discomfort, Doctronic can help evaluate your symptoms and determine if further testing is needed.
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