Fatty liver, also known as hepatic steatosis, is a condition in which there is an excessive accumulation of fat within the liver cells. The liver is responsible for many important functions such as detoxifying the blood, producing bile, and regulating glucose and lipid metabolism. Fatty liver can interfere with these functions and may lead to inflammation and scarring of the liver, also known as liver fibrosis or cirrhosis, which can be serious and potentially life-threatening.
There are two main types of fatty liver:
- Non-alcoholic fatty liver disease (NAFLD): is the most common type of fatty liver, and it occurs in people who drink little or no alcohol. It’s associated with obesity, type 2 diabetes, and metabolic syndrome, which is a group of risk factors that increase the risk of heart disease, stroke and diabetes.
- Alcoholic fatty liver disease (AFLD): is caused by the excessive consumption of alcohol and it’s the second most common type of fatty liver. Long-term heavy alcohol use can lead to liver damage, inflammation, and scarring, which can ultimately lead to liver failure.
Symptoms of fatty liver are often not present, or very mild and non-specific, such as fatigue, abdominal pain, or jaundice (yellowing of the skin and eyes). That’s why many cases of fatty liver go undiagnosed, and it’s usually discovered during a routine medical exam or when a person is being evaluated for other liver related issues.
Treatment of fatty liver depends on the underlying cause, but in general, it involves lifestyle changes such as a healthy diet, regular exercise, weight loss, and limiting alcohol consumption. In some cases, medication may be needed to control blood sugar or cholesterol levels.
What causes fatty liver?
There are several factors that can contribute to the development of fatty liver, including:
- Obesity and metabolic syndrome: Excess weight, especially in the form of abdominal fat, is a major risk factor for fatty liver. Metabolic syndrome, a group of risk factors that increase the risk of heart disease, diabetes, and stroke, is also associated with fatty liver.
- Insulin resistance: Insulin resistance is a condition in which the body’s cells do not respond properly to insulin, a hormone that regulates glucose metabolism. This can lead to an accumulation of fat in the liver.
- High triglycerides: Triglycerides are a type of fat found in the blood. High levels of triglycerides in the blood are associated with fatty liver.
- High sugar intake: Excess sugar intake can lead to insulin resistance and fat accumulation in the liver.
- High alcohol consumption: Long-term heavy alcohol consumption is a leading cause of fatty liver and can cause liver damage, inflammation, and scarring, which can ultimately lead to liver failure.
- Rapid weight loss: Rapid weight loss can cause the liver to release fat into the bloodstream, leading to fat accumulation in the liver.
- Certain medications: Some medications can cause fatty liver as a side effect, including amiodarone, tamoxifen, and methotrexate.
- Genetic factors: Research suggests that there may be a genetic component to fatty liver, with certain inherited disorders, such as hemochromatosis, that can increase the risk of fatty liver.
Symptoms of fatty liver
Fatty liver is often a silent disease, meaning that it may not produce any symptoms in the early stages. However, as the condition progresses, it may cause the following symptoms:
- Fatigue: People with fatty liver may feel tired and sluggish.
- Abdominal pain or discomfort: Fatty liver can cause discomfort or dull pain in the upper right abdominal area.
- Jaundice (yellowing of the skin and eyes): Fatty liver can cause the accumulation of bilirubin, which is a yellow pigment, in the blood.
- Nausea and vomiting
- Loss of appetite
- Weight loss
- Itchy skin
- Spider angiomas: these are red, raised spots with small, thin, spidery lines radiating out from the spot.
Is fatty liver dangerous?

Fatty liver can be dangerous if it progresses to more serious liver diseases, such as nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and liver failure.
Nonalcoholic steatohepatitis (NASH) is the stage of the disease where fat accumulation causes inflammation and injury in the liver cells leading to the development of scar tissue. This can lead to fibrosis, which is a condition where the liver’s structure is altered due to the formation of scar tissue, causing the liver to lose its ability to function properly. If fibrosis progresses to cirrhosis, the liver is heavily scarred, hardened, and unable to function properly, which can lead to liver failure, a life-threatening condition that requires a liver transplant.
It’s important to note that fatty liver is often asymptomatic, meaning that it can go unnoticed for years. However, early detection and treatment can prevent the progression of the disease and potential complications. Making lifestyle changes such as maintaining a healthy weight, eating a healthy diet, exercising, and limiting alcohol consumption can prevent the progression of fatty liver and protect the liver from damage.
Also, the certain population has a higher risk for developing NASH and progressive liver disease such as people with obesity, diabetes, metabolic syndrome, and high triglycerides. Early detection and management of these risk factors can prevent the progression of fatty liver to NASH.
Fatty liver treatment
The treatment of fatty liver depends on the underlying cause and the stage of the disease. However, in general, treatment involves lifestyle changes and, in some cases, medication.
- Lifestyle changes:
- Weight loss: Losing weight, through a healthy diet and regular exercise, is one of the most effective ways to reduce the fat in the liver.
- Healthy diet: A diet low in saturated and trans fats, added sugars, and cholesterol, and high in fruits, vegetables, lean protein, and whole grains is recommended.
- Limiting alcohol consumption: Heavy alcohol consumption is a leading cause of fatty liver, so it’s important to limit alcohol intake or quit alcohol entirely.
- Medications:
- Medications such as pioglitazone, metformin, or vitamin E may be used to help improve insulin sensitivity and reduce fat accumulation in the liver.
- Medications that help lower cholesterol or triglycerides in the blood, such as statins or fibrates, can be used to reduce the fat in the liver.
- Bariatric surgery may be considered for morbidly obese individuals as it leads to rapid weight loss and improvement in liver enzymes.
Fatty liver symptoms in females
Fatty liver is a condition that affects both males and females, but the symptoms can be similar regardless of gender. Symptoms of fatty liver can include:
- Fatigue: People with fatty liver may feel tired and sluggish.
- Abdominal pain or discomfort: Fatty liver can cause discomfort or a dull pain in the upper right abdominal area.
- Jaundice (yellowing of the skin and eyes): Fatty liver can cause the accumulation of bilirubin, which is a yellow pigment, in the blood.
- Nausea and vomiting
- Loss of appetite
- Weight loss
- Itchy skin
- Spider angiomas: these are red, raised spots with small, thin, spidery lines radiating out from the spot.
In women, fatty liver can develop during pregnancy and the postpartum period, a condition known as gestational or postpartum steatosis.
How to reduce fatty liver?
Reducing fatty liver involves making lifestyle changes and, in some cases, taking medications. Some ways to reduce fatty liver include:
- Weight loss: Losing weight, through a healthy diet and regular exercise, is one of the most effective ways to reduce the fat in the liver. Aiming for a weight loss of 5-10% of your current weight can result in the improvement of liver enzymes and reduce inflammation.
- Healthy diet: Eating a diet low in saturated and trans fats, added sugars and cholesterol, and high in fruits, vegetables, lean protein and whole grains can help reduce fat in the liver. It’s important to avoid processed foods and added sugars that can contribute to the development of a fatty liver.
- Regular exercise: Regular physical activity can help burn fat, lower insulin resistance and improve cardiovascular health. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.
- Limit alcohol consumption: Heavy alcohol consumption is a leading cause of fatty liver, so it’s important to limit alcohol intake or quit alcohol entirely.
- Control underlying conditions: conditions such as diabetes, metabolic syndrome and high triglycerides should be properly managed in order to reduce fat in the liver.
- Medications:
- Medications such as pioglitazone, metformin, or vitamin E may be used to help improve insulin sensitivity and reduce fat accumulation in the liver.
- Medications that help lower cholesterol or triglycerides in the blood, such as statins or fibrates, can be used to reduce the fat in the liver.
- Bariatric surgery may be considered for morbidly obese individuals as it leads to rapid weight loss and improvement in liver enzymes.
Life expectancy with fatty liver disease
In the early stages of fatty liver disease, such as nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH), the prognosis is generally good and the life expectancy is not significantly affected. However, if left untreated, NASH can progress to liver fibrosis and eventually to cirrhosis. Cirrhosis can be a serious and life-threatening condition and it can lead to complications such as liver failure, liver cancer, or portal hypertension, which can significantly reduce life expectancy.
It’s important to note that fatty liver disease is often asymptomatic, so many people may not know they have it. Early detection and treatment can prevent the progression of the disease and the potential complications that can occur.
Risk factors that can increase the progression of the disease include obesity, metabolic syndrome, high blood pressure, high blood sugar, and high triglycerides. By addressing these risk factors, it can lower the risk of progression of the disease and improve overall health and life expectancy.
Fatty liver diet
A healthy diet can play an important role in reducing fat in the liver and preventing the progression of fatty liver disease. Here are some general guidelines for a fatty liver diet:
- Limit added sugars: Added sugars can contribute to the development of fatty liver and other health problems. Avoid sugary drinks, candy, and desserts.
- Limit saturated fats: Saturated fats are found in animal products such as butter, cheese, and red meat. They can contribute to the development of fatty liver and other health problems. It’s best to limit the intake of these foods or replace them with healthier options such as fish, skinless chicken, and plant-based proteins.
- Increase fiber intake: Eating foods high in fiber, such as fruits, vegetables, whole grains, and legumes can help reduce fat in the liver.
- Include healthy fats: Not all fats are bad for you. Including healthy fats like olive oil, avocado, nuts and seeds, and fatty fish like salmon, can help reduce fat in the liver.
- Control portion sizes: Eating large meals can lead to weight gain and contribute to the development of fatty liver. Instead, try to control portion sizes, and eat smaller, more frequent meals throughout the day.
- Avoid processed foods: Processed foods are often high in added sugars and saturated fats, and can contribute to the development of the fatty liver.
- Consult with a dietitian: Consulting a dietitian or nutritionist can be helpful in creating an individualized diet plan that addresses your specific needs and can provide guidance on nutrient needs and food choices.
Fatty liver symptoms on skin
Fatty liver is a condition where there is an excessive accumulation of fat within the liver cells. In many cases, it may not produce any symptoms, or the symptoms can be very mild and non-specific. However, as the condition progresses, it may cause certain skin-related symptoms.
- Jaundice: Jaundice is a yellowing of the skin and eyes that occurs when there is too much bilirubin in the blood. Bilirubin is a yellow pigment that is produced by the breakdown of red blood cells. In people with fatty liver, the liver may not be able to properly process bilirubin, leading to jaundice.
- Spider angiomas: Spider angiomas are small, red, raised spots that have thin, spidery lines radiating out from them. They are commonly seen in people with liver disease, including fatty liver.
- Itchy skin: Fatty liver can cause itching, which can be caused by the accumulation of bile salts in the blood, a condition known as pruritus.
- Bruising easily: As fatty liver progresses, it can lead to reduced production of clotting factors by the liver, leading to easy bruising.
Best medication for fatty liver
The best medication for fatty liver depends on the underlying cause of the condition and the stage of the disease. Here are some medications that may be used to treat fatty liver:
- Insulin sensitizers: Medications such as pioglitazone and metformin can help improve insulin sensitivity and reduce fat accumulation in the liver.
- Cholesterol-lowering medications: Medications such as statins and fibrates can help lower cholesterol and triglycerides in the blood, which can reduce fat in the liver.
- Vitamin E: Vitamin E has been shown to be effective in reducing liver fat content in people with nonalcoholic fatty liver disease.
- Bariatric surgery: In morbidly obese individuals, bariatric surgery may be considered as it leads to rapid weight loss and improvement in liver enzymes.