Fatty liver disease is one of the most common chronic liver conditions worldwide. Contrary to popular belief, it does not only affect people with obesity; individuals with normal or lower weight can also develop it, especially if they have conditions like diabetes or metabolic disorders.
The danger of fatty liver lies in its silent progression. Fat gradually accumulates in the liver, causing inflammation and cell damage over time, which can eventually lead to cirrhosis or liver failure if left untreated.
What Is Fatty Liver Disease?
According to the Cleveland Clinic, a healthy liver contains a small amount of fat. Fatty liver disease develops when fat in the liver exceeds about 5% of the liver’s weight.
There are several types of fatty liver disease:
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Early stage: Fat accumulation only
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Advanced stage (MASH – Metabolic Dysfunction-associated Steatohepatitis): Fat causes chronic inflammation and liver cell damage, which may progress to cirrhosis or liver cancer if untreated
Causes of Fatty Liver
The main risk factors include:
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Obesity or excess abdominal fat
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Type 2 diabetes
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High cholesterol and triglycerides
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High blood pressure
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Insulin resistance and metabolic syndrome
Important note: Not all fatty liver patients are overweight. Even people with average weight can have fatty liver if they have metabolic issues.
Silent Symptoms of Fatty Liver
The real challenge is that symptoms often don’t appear early, so diagnosis may occur in advanced stages. Key warning signs include:
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Chronic fatigue without an obvious reason
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Pain or heaviness in the upper right abdomen
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Unexplained weight loss or muscle loss
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Swelling of the abdomen or legs in later stages
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Yellowing of the skin and eyes (jaundice) in cases of cirrhosis or liver failure
Complications of Fatty Liver
If ignored, fatty liver can lead to:
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Cirrhosis and permanent liver scarring
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Liver failure, sometimes requiring transplantation
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Increased risk of liver cancer
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Higher risk of cardiovascular disease
Diagnosis
Since symptoms may overlap with other conditions, accurate diagnosis requires:
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Blood tests: To check liver enzymes, fat levels, blood sugar, and inflammation markers
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Imaging: Ultrasound, CT scan, or advanced techniques like FibroScan or MRI to measure liver fat and stiffness
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Liver biopsy: The most precise method to assess inflammation and fibrosis, used for severe cases
Prevention of Fatty Liver
Doctors recommend lifestyle changes as the primary preventive measures:
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Maintain a healthy weight
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Aim to reduce 7–10% of excess body weight to lower liver fat
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Mediterranean diet
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Rich in vegetables, fruits, whole grains, legumes, olive oil, nuts, and fish
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Supports both liver and heart health
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Regular exercise
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150–300 minutes per week of moderate activity
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Manage diabetes, blood pressure, and cholesterol
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Follow medical prescriptions to control risk factors that drive liver fat accumulation
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Treatment
Historically, there was no approved medication specifically for fatty liver; treatment focused on weight loss and lifestyle improvement, sometimes with supportive therapies like vitamin E.
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