Could I Have a Fatty Liver? Why Should I Care?

Nonalcoholic Fatty Liver Disease (NAFLD) is the term used for the buildup of extra fat within liver cells in individuals who consume little or no alcohol. This buildup of fat can cause inflammation and fibrosis (scarring) of the liver.

NAFLD is extremely common, and it is recognized as the most common liver disorder in western countries, including in adolescents and preadolescents. It affects about 1 in 25 adults in the United States (3 to10 times more common than Hepatitis C). NAFLD is diagnosed in approximately 8 out of 10 patients who are evaluated for abnormal liver tests.

What Causes Fatty Liver?
The exact cause is not known, but the main risk factors include obesity or overweight; diabetes; high cholesterol and/or triglycerides; and high blood pressure. Rapid weight loss and poor eating habits, as well as medications, may also cause fatty liver even in patients without those risk factors.

Most of the time, NAFLD does not cause any serious liver problems and most people with fatty liver will live as long as those without it; however, the disease can progress, leading to inflammation of the liver tissue, which is also called Nonalcoholic Steatohepatitis (NASH). The persistent inflammation can cause scarring, which ultimately can lead to cirrhosis of the liver. Patients with cirrhosis may develop complications such as liver cancer and liver failure, and may need liver transplantation. It is difficult to predict the course of this disease, but we know that patients who are older, diabetics and/or obese are the ones at higher risk for worse disease.

Why Should You Ask Your Doctor About Fatty Liver?
Fatty liver is usually silent; it causes no signs or symptoms until it is very advanced. It is commonly first noted by the finding of abnormal liver tests on routine blood work. If diagnosed early, liver damage can be prevented.

If your doctor suspects that you may have fatty liver, you will need blood tests to help exclude other causes of liver disease. Imaging studies (such as ultrasound) will likely be ordered and they may show fat accumulation in the liver. In some cases, a liver biopsy may be needed to confirm the diagnosis and/or to determine the severity of the disease.

Is There a Cure?
NAFLD cannot be cured, but it can be controlled, and prevented. There is no medication proven to effectively treat fatty liver disease. The treatment/prevention is focused on diet and exercise, aiming gradual weight loss and tight control of the associated conditions, such as diabetes, high blood pressure and high cholesterol/triglycerides.

If you have been diagnosed with fatty liver, you should strive to maintain a healthy weight with balanced diet and exercise; limit alcohol intake; only take medicines that you need and follow dosing recommendations; see your doctor regularly and consider a consultation with a liver specialist.