What Is Fatty Liver Disease?

Fatty liver is also known as hepatic steatosis. It happens when fat builds up in the liver. Having small amounts of fat in your liver is normal, but too much can become a health problem.

There are two types of fatty liver: metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known nonalcoholic fatty liver disease or NAFLD) and alcoholic fatty liver disease (AFLD). MASLD is usually preventable and is linked to obesity, type 2 diabetes, and diet. It affects 25 to 30% of people living in the United States and Europe. AFLD is linked with drinking excessive amounts of alcohol.

Early-stage fatty liver disease can often be reversed with lifestyle changes. When damage to the liver continues beyond its capacity to repair itself, liver damage and health issues often result. If left untreated, fatty liver disease can progress to cirrhosis, which can lead to liver failure and may require a liver transplant.

What Is the Liver?

The liver is a large reddish-brown digestive organ that sits on the right side of your abdomen. It plays critical roles in digestion and maintaining overall health.

Among the jobs of the liver:

• The liver produces bile, which helps break down fat so it can be absorbed in the digestive tract.
• Biotransformation of toxic substances from normal metabolism, medications, and alcohol in the liver prepares them for removal from your body.
• The liver produces proteins.
• It makes and recycles a wide variety of essential biochemicals.

The liver commonly repairs itself when its cells become damaged.

Fatty Liver Disease Symptoms

In its early stages, fatty liver disease usually does not have symptoms.

As it progresses, fatty liver disease can cause:

• Loss of appetite
• Abdominal pain
• Nausea and vomiting
• Jaundice (a yellow tone to your skin)

Acute fatty liver of pregnancy is a rare but serious complication that can develop during the third trimester of pregnancy. Symptoms include nausea and vomiting, poor appetite, pain in the upper-right abdomen, headache, generally feeling sick, fatigue, and jaundice.

Causes

Risk factors for developing fatty liver disease include:

• Excessive use of alcohol (AFLD)
• Higher body weight or obesity
• Diabetes or pre-diabetes
• Diet high in sugar and processed foods
• Hyperlipidemia, especially with high triglycerides (a blood lipid)
• Low physical activity
• Digestive issues
• Genetic predisposition

Fatty liver can also develop with rapid weight loss or as a side effect of certain medications. Many of the risks of MASLD can be addressed with changes to lifestyle choices.

Diagnosis

Fatty liver disease is diagnosed through a medical exam, and various tests, including liver function and blood count tests, or imaging tests. Your healthcare provider will ask about your medical history including alcohol intake, and your weight and diet.

Metabolic dysfunction-associated steatohepatitis (MASH, formerly known as nonalcoholic steatohepatitis or NASH) is a type of MASLD, and this occurs when more than 5% of the liver is fat and inflammation is also present. MASH is a serious condition that can progress to scarring, an increased risk for cancer, and liver failure if it's not treated.

Treatment

Changing your lifestyle choices, such as improving your diet and reducing alcohol intake, are the primary treatments for fatty liver disease.

MASLD

For MASLD, making lifestyle changes that include increasing your physical activity and improving your diet to include more fruits, vegetables, and whole grains will help reverse fatty liver.

While certain nutritional supplements have shown promise in the treatment of fatty liver, more research is needed. Working with a qualified nutritionist can help you make effective changes and determine if a nutritional supplement might be helpful.

If medication may be causing your fatty liver disease, your healthcare provider will recommend how to replace that medication.

AFLD

The primary treatment for alcoholic fatty liver disease is to stop drinking alcohol. Therapists are available who can help, or you can participate in an alcohol recovery program. These programs sometimes use treatments with medicines that can reduce cravings for alcohol, or that make you feel ill if you drink alcohol.

Coping

As with many chronic lifestyle conditions, a diagnosis of fatty liver disease can cause you to blame yourself for your illness. You may wonder how serious your condition is and how long you have until your condition is life-threatening.

Speaking with a therapist can be helpful to process the difficult emotions that can come with a diagnosis like fatty liver disease. Work closely with your medical team to determine the best course of action for you and your individual case, as well as work with your therapist to handle the emotional aspect of your diagnosis.

A Word From Verywell

Fatty liver disease is on the rise around the world due to our modern lifestyles that are often filled with stress, a food supply featuring tasty yet poor-quality food (high in added sugars and low in nutrients), and fewer opportunities for adequate physical activity. So, you are not alone in your struggle with fatty liver.

While it may seem daunting, you can begin to make small changes that can, over time, add up to better long-term health. There are many healthful ways to manage stress. No matter who you are, there are people and resources in your community that can help you find the help and support you need to begin to change. The most important part is to keep trying. Regardless of where your health is now, you have small opportunities to improve your health each day.