Fatty Liver Disease
Also known as MASLD, NAFLD, Hepatic steatosis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is fatty liver disease?
Fatty liver disease is the build up of fat within liver cells, most commonly associated with obesity, type 2 diabetes and metabolic syndrome. Many people have no symptoms and it is found incidentally on blood tests or ultrasound. A minority progress to inflammation, fibrosis and cirrhosis, so assessing fibrosis risk is the key clinical step.
Causes
- Insulin resistance driving fat deposition in the liver
- Obesity, particularly central adiposity
- Type 2 diabetes
- High triglycerides and metabolic syndrome
- Alcohol in alcohol related fatty liver disease
- Some medicines and rapid weight loss
Symptoms
- Often no symptoms at all
- Fatigue
- Vague discomfort in the upper right abdomen
- Abnormal liver blood tests found incidentally
- Features of advanced liver disease such as jaundice or swelling in late stages
Risk factors
- Obesity
- Type 2 diabetes and insulin resistance
- High blood pressure and dyslipidaemia
- Polycystic ovary syndrome
- Obstructive sleep apnoea
Diagnosis
- Liver blood tests, which can be normal despite significant disease
- Ultrasound showing a bright fatty liver
- FIB 4 score or similar non invasive fibrosis assessment
- Transient elastography to measure liver stiffness
- Exclusion of viral hepatitis and alcohol as causes
- Liver biopsy in selected cases
Treatment
- Gradual weight loss, with 7 to 10 percent producing meaningful improvement
- Regular physical activity independent of weight change
- Optimising diabetes and lipid control
- Minimising or stopping alcohol
- Vaccination against hepatitis A and B
- Specialist referral when significant fibrosis is suspected
Self care
- Aim for gradual weight loss of around 7 to 10 percent
- Exercise regularly, which helps liver fat even without weight loss
- Cut sugary drinks and refined carbohydrates
- Minimise or stop alcohol
- Manage diabetes and cholesterol actively
- Avoid unnecessary supplements and herbal products
- Get vaccinated against hepatitis A and B
When to see a doctor
Book an appointment if:
- Abnormal liver blood tests on routine testing
- Fatigue with upper right abdominal discomfort
- Diabetes or obesity, to have fibrosis risk assessed
- Rising fibrosis scores
- Before starting medicines that affect the liver
- Weight loss efforts not producing improvement
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Keep to a healthy weight
- Limit sugary drinks and ultra processed food
- Stay physically active
- Limit alcohol
- Manage diabetes, blood pressure and cholesterol
- Have fibrosis risk assessed if you have metabolic risk factors
Outlook
Simple fatty liver often remains stable and can reverse completely with weight loss and activity. A minority progress to inflammation and fibrosis, and a smaller number to cirrhosis. Fibrosis stage is the strongest predictor of outcome, which is why non invasive fibrosis scoring matters more than liver enzyme levels.
Common questions
Does a normal liver blood test rule out a problem?
No. Liver enzymes can be entirely normal even when significant fibrosis is present, which is why fibrosis scores such as FIB 4 and elastography are used rather than relying on enzymes alone.
How much weight loss makes a difference?
Losing around 5 percent of body weight reduces liver fat, 7 percent can improve inflammation, and about 10 percent gives the best chance of improving fibrosis. Gradual sustained loss is more effective than rapid dieting.
Is any alcohol safe with fatty liver?
Alcohol adds a second injury to a liver already under metabolic stress. Most specialists advise minimising intake, and abstinence is recommended where fibrosis or cirrhosis is present.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.