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Fatty Liver: Causes, Symptoms, Treatment, And More


The liver is the body’s largest organ on the right upper side of the abdomen. It is responsible for the removal of toxic waste out of the body along with assisting in digestion and storing energy.

Some of the substances lead to the development of a condition called Fatty Liver, which hinders the normal functioning of the organ.

This common disease in western countries is also referred to as hepatic steatosis. So let’s understand Fatty Liver disease in detail.

What Is Fatty Liver Disease?

Fatty liver disease is when the hepatocytes (liver cells) build up fat. This[1] excess of fat leads to inflammation of the liver.

Usually, the liver stores some amount of fat, but if the amount of fat exceeds 10% of the weight of the liver, then it leads to the development of fatty liver disease.

Fatty liver is dangerous as it leads to inflammation causing a condition called steatohepatitis. This inflammation may sometimes be linked to overconsumption of alcohol.

In such cases, inflation is referred to as alcoholic steatohepatitis. This inflamed condition may prolong for a long duration and become scarred and harden over time.

This hardening leads to liver cirrhosis and may further lead to liver failure.

Fatty Liver Symptoms

Nonalcoholic fatty liver usually doesn’t show any signs or symptoms. If it shows, symptoms may include[2]:

  • Pain in the upper right abdomen
  • Fatigue
  • Abdominal swelling
  • Enlarged spleen
  • Yellowing of skin and eyes
  • Extreme tiredness and mental confusion
  • Weakness
  • Loss of appetite, Nausea
  • Weight loss
  • Higher level of liver enzymes

What Is Nonalcoholic Fatty Liver Disease?

It is the disease in which fat gets deposited in your liver due to slow metabolism and obesity. In the early stages of the disease, it may only be diagnosed using X-rays by doctors. No apparent signs of an illness may be seen.

Further progression of the disease[1] causes chronic liver inflammation that may be observed with the yellowing of the eyes and abdominal pain.

  1. Fibrosis Stage

    In the third stage of the disease, a fibrosis-like condition occurs[3] wherein the organ’s tissues are converted into scar tissue.

    But it still doesn’t hinder the normal functioning of the organ. The final stage of NAFLD is liver cirrhosis.

    This stage occurs only when a prolonged fat build-up process has taken place in the liver.

    This situation only occurs if there has been persistent inflammation for years and you haven’t been diagnosed and treated for the disease.

  2. Shrinking Of Liver

    The liver starts to undergo shrinking, which is an irreversible[4] process.
    This shrinking may ultimately stop the functioning of the liver, leading to liver failure and Liver cancer.

    This failure may only occur if you do not take measures to overcome the disease in the early stage.

    When the liver is completely fibrotic and shrunken the liver is considered cirrhotic.

What Is Alcoholic Fatty Liver Disease?

Excessive drinking of alcohol may lead to fat accumulation in the liver causing fatty liver disease. The liver functions to break down alcohol in your body.

If you ingest more alcohol, your liver will be pressurized to work more than its capacity. If this is persistent, it leads[5] to fat accumulation in the liver.

Mechanism Of Alcohol-Induced Fatty Liver

Alcohol or specifically ethanol increases the fatty acid synthesis. Alcohol is metabolized to acetaldehyde by the enzyme Alcohol dehydrogenase present in the liver.

This acetaldehyde, in turn, causes increased synthesis of sterol regulatory binding protein ( transcription factor for fatty acid synthesis).

This SRBP improves the process of lipogenesis. Also, the increased amount of acetaldehyde leads to a decreased beta-oxidation process of breakdown of lipids in the body.

This beta-oxidation further adds to increasing levels of triglycerides in the body. The liver is a storage house for lipids. Increased levels of fat in the body may lead to accumulation of it in the liver.

Fatty Liver AKA Non-Alcoholic Fatty Liver Diet

Reducing excess weight is the primary treatment for reversing fatty liver disease. A proper fatty liver diet would help to reduce weight and overcome the damage.

A Diet Plan for fatty liver disease includes :

  • Eat more fruits and vegetables
  • Fiber-rich foods – legumes, green leafy vegetables, and whole grains- prevent fat build-up in the body.
  • Low carbohydrate[6] diet
  • Fish and nuts – Fish and nuts help reduce[7] the liver’s inflammation.
  • Turmeric helps reduce[8] the number of abnormal enzymes in the fatty liver, avoid bacterial infection, and also reduces inflammation.
  • Sunflower seeds – are rich in antioxidants helpful to increase heavy acid breakdown.

Additionally, you should avoid beverages that have added refined sugar and high amounts of salt.

Fatty Liver Treatment

You may not be able to treat fatty liver, but you may prevent or reduce the condition.

If you get diagnosed with the disease, start taking measures[1] to reverse the condition. That’s the only treatment you may undergo to treat the fatty liver.

If you are obese and have metabolic syndrome, you must do a liver functioning test or ultrasound followed by MRI if needed.

A special ultrasound called an elastography is also diagnostic for cirrhosis to check the liver condition so that you may overcome it in the early stages.

As the symptoms may not be detected by direct analysis, you must do a blood test to check the presence of disease in the early stages.

You may consider improving your lifestyle to treat your fatty liver conditions. If you are obese and have NAFLD, as per the primary treatment, consider reducing your weight and adopting a healthy lifestyle.

Take necessary therapy for high cholesterol levels, high blood pressure, or diabetes if you suffer from these issues.

If you are suffering from alcoholic fatty liver disease, you should reduce or completely stop drinking alcohol.

There are no FDA-approved medications for fatty liver disease but some are used to help manage and reduce fat deposition. 

These are medications such as Metformin, Vitamin E, Ursodeoxycholic acid, ezetimibe, N-3 polyunsaturated fatty acids (like fish oil), probiotics, and green tea.

A liver transplant may be the only treatment for damaging the liver. Before the liver stops functioning, the doctor must look for a donor and transplant procedures.

Once detected with this disease, you must always stay on alert, and strictly follow the instruction[9] on how to manage it from your health expert.

What Causes Fatty Liver?

Anything that hinders the fatty acid breakdown for a prolonged time or more fatty acid synthesis may lead to fatty liver disease.

Significant causes of that include:

  • Obesity

    Being overweight is the primary[10] cause of nonalcoholic fatty liver disease. This, in particular, means having a lot of fat around his waist.

  • Type-2 Diabetes

    When your body becomes resistant[11] to insulin and doesn’t respond to regular insulin release, that condition is called diabetes type 2.

    You require external insulin dosage for your body cells to take up glucose and utilize it for metabolic activities.

  • Metabolic Syndrome

    A condition[12] in which you suffer from high blood pressure, insulin resistance, and obesity is called metabolic syndrome.

  • Certain Medications

    You are taking medications with high sterols and steroidal formulations for fungal treatment for a prolonged duration.

  • Smoking and Alcohol Consumption

    Drinking excess[5] alcohol daily may lead to alcohol Fatty liver disease.

Life Expectancy With Fatty Liver Disease

Progression of the disease may lead to liver cirrhosis, which means wearing out of the skin and tissues of the organs. If this progresses further, it may lead to liver damage.

If you already suffer from problems like diabetes and high blood pressure, then fatty liver disease may lead to severe problems such as heart and kidney diseases.

Alcoholic fatty liver disease is often associated with viral hepatitis B or C. As alcohol also lowers the immune system, viruses may quickly colonize and cause a progressive infection.

Hepatitis is the worst-case scenario in alcoholic fatty liver disease. While some may also suffer from Jaundice disease. Thirty percent of people with fatty liver develop liver fibrosis.

At the same time, only 20% develop end-stage liver cirrhosis that may lead to liver cancer or liver failure.

According to several studies, FLD reduces women’s life expectancy by 4.2 years, while for men, it reduces by 4.4 years.

Studies[13] show, if the liver condition is reversed, both man and woman may survive for long, but if the disease progresses to the last stage, it may be fatal.

How To Reverse Fatty Liver Disease?

You may practice[14] a few things to reverse fatty liver condition to normal.

If you are suffering from nonalcoholic heavy liver symptoms, you may follow the following to change it.

  1. Lose Weight

    As obesity is the primary reason for nonalcoholic fatty liver disease, you need to shed the excess fat[15] from your body to get rid of the disease.

    It would help if you were slow in this process. Don’t hurry and lose lots of pounds in a week.

    You need to focus on losing fat from your body rather than just losing weight.

  2. Lower The Consumption Of Triglycerides

    You need to lower the direct source of lipids in your body. Whether they are part of your medicine or diet, you need to reduce both of them or get back to normal.

  3. Control Diabetes

    This means controlling[15] your sugar (glucose) consumption. Glucose and insulin hinder the process of the breakdown of fat in your body.
    Thus it’s necessary to eat a carbohydrate-deficient diet.


  4. Balanced Diet

    Include more healthy[16] foods and avoid fast foods. This will have to keep your metabolism reasonable.

  5. Physical Activity

    Increase[14] your physical activity. This will help burn fat in your body and boost your metabolism, which will speed the process of lipid breakdown.

  6. Stop Smoking

    Smoking has shown some contribution to causing fatty liver. To avoid it, you must quit[17] smoking.


Irregular habits mainly cause fatty liver disease. Weird eating habits lead to obesity and an increase in fat deposition, increasing the risk of nonalcoholic fatty liver.

On the other hand, regular, and excessive alcohol consumption leads to alcoholic fatty liver.

If we improve[14] our lifestyle by having a balanced diet, avoiding destructive drinking habits, and exercising daily, we may reduce the chances of many diseases, including Fatty liver disease.

Under any conditions, if you notice any symptoms of fatty liver in your body, you must consult your health expert without delay.

17 References/Sources

Working4Health prefers using primary and verified references. We have strict sourcing guidelines and our primary references include peer-reviewed research, academic, and medical institution studies.

  1. Fatty Liver Disease Available from: https://medlineplus.gov/fattyliverdisease.html
  2. Symptoms & Causes of NAFLD & NASH Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/symptoms-causes
  3. Page Axley, Sandhya Mudumbi, Shabnam Sarker et al. Patients with stage 3 compared to stage 4 liver fibrosis have lower frequency of and longer time to liver disease complications PLoS One. 2018; 13(5): e0197117. Published online 2018 May 10. doi: 10.1371/journal.pone.0197117
  4. Pujitha Kudaravalli; Savio John. Nonalcoholic Fatty Liver Last Update: May 8, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541033/
  5. Roshan Patel; Matthew Mueller. Alcoholic Liver Disease Last Update: January 19, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546632/
  6. Metin Basaranoglu, Gokcen Basaranoglu, and Elisabetta Bugianesi Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction Hepatobiliary Surg Nutr. 2015 Apr; 4(2): 109–116. doi: 10.3978/j.issn.2304-3881.2014.11.05
  7. Yingqiu Li, Fan Zhao, Qiayu Wu, et al. Fish oil diet may reduce inflammatory levels in the liver of middle-aged rats Sci Rep. 2017; 7: 6241. Published online 2017 Jul 24. doi: 10.1038/s41598-017-06506-3
  8. Bethesda LiverTox: Clinical and Research Information on Drug-Induced Liver Injury Last Update: May 11, 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548561/
  9. Juan P Arab, Roberto Candia, Rodrigo Zapata, et al. Management of nonalcoholic fatty liver disease: An evidence-based clinical practice review World J Gastroenterol. 2014 Sep 14; 20(34): 12182–12201. Published online 2014 Sep 14. doi: 10.3748/wjg.v20.i34.12182
  10. Elisa Fabbrini, Shelby Sullivan, and Samuel Klein Obesity and Nonalcoholic Fatty Liver Disease: Biochemical, Metabolic and Clinical Implications Hepatology. 2010 Feb; 51(2): 679–689. doi: 10.1002/hep.23280
  11. Mala Dharmalingam and P. Ganavi Yamasandhi Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus Indian J Endocrinol Metab. 2018 May-Jun; 22(3): 421–428. doi: 10.4103/ijem.IJEM_585_17
  12. P Paschos, K Paletas Non alcoholic fatty liver disease and metabolic syndrome Hippokratia. 2009 Jan;13(1):9-19. Available from: https://pubmed.ncbi.nlm.nih.gov/19240815/
  13. S Dam-Larsen, M Franzmann, I B Andersen, et al. Long term prognosis of fatty liver: risk of chronic liver disease and death Gut. 2004 May; 53(5): 750–755. doi: 10.1136/gut.2003.019984
  14. Min-Sun Kwak and Donghee Kim Non-alcoholic fatty liver disease and lifestyle modifications, focusing on physical activity Korean J Intern Med. 2018 Jan; 33(1): 64–74. Published online 2017 Dec 6. doi: 10.3904/kjim.2017.343
  15. Harikrashna B. Bhatt and Robert J. Smith Fatty liver disease in diabetes mellitus Hepatobiliary Surg Nutr. 2015 Apr; 4(2): 101–108. doi: 10.3978/j.issn.2304-3881.2015.01.03
  16. Eating, Diet, & Nutrition for NAFLD & NASH Available from: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition
  17. Abdel-Rahman El-Zayadi Heavy smoking and liver World J Gastroenterol. 2006 Oct 14;12(38):6098-101. doi: 10.3748/wjg.v12.i38.6098. Available from: https://pubmed.ncbi.nlm.nih.gov/17036378/

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