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What Is Fatty Liver?
Understanding the Silent Liver Condition
Jovanna Arce
Physician Reviewed
Sep 25, 2025
What is Fatty Liver?
Fatty liver, also known as hepatic steatosis, is a condition where an excessive amount of fat accumulates in the hepatocytes, or liver cells. Some fat accumulation in the liver is normal, however when this buildup of fat gets to be greater than 5% of the liver’s weight, this can lead to inflammation, liver damage, and even cirrhosis. These effects are a cause for concern as they impair the liver’s ability to perform its essential functions.
What are the essential functions of the liver?
The liver plays crucial roles in a multitude of bodily processes, including but not limited to:
Digestion and metabolism
Filtering and removing toxins from the bloodstream.
Producing proteins involved in blood clotting.
Hormone regulation
Storage of nutrients and vitamins
Production of bile and cholesterol
When too much fat is stored in the liver, these processes are hindered and can lead to increased risk of metabolic complications, cardiovascular disease, or even liver cancer.
Types of Fatty Liver Disease
There are two main types of fatty liver disease, and these are known as metabolic dysfunction-associated fatty liver disease (MAFLD) or alcoholic fatty liver disease (AFLD). Non-alcoholic fatty liver disease or NAFLD is often used interchangeably with MAFLD, however, MAFLD is the more widely accepted term today. The key difference between the two types of fatty liver disease is that MAFLD is caused by a combination of metabolic risk factors, whereas AFLD is caused by prolonged or heavy alcohol consumption.
Who is at risk?
There are several risk factors that can contribute to fatty liver disease. Some of the most common risk factors include obesity, type 2 diabetes or insulin resistance, elevated cholesterol or triglyceride levels, high blood pressure, genetics, and even poor diet and sedentary lifestyle. There are other causes of fatty liver disease such as certain medications, hormone imbalances or fluctuations, or even pregnancy, however these are typically acute cases of fatty liver disease.
Symptoms of Fatty Liver Disease
Fatty liver disease is known as a “silent disease” because it often comes with no signs or symptoms, especially in the early stages of the disease. A vast majority of people who have fatty liver can live years without even knowing or ever being diagnosed with the condition. Unfortunately, this allows for fatty liver to progress without notice and oftentimes symptoms present in the late stages of disease, when the damage is far too advanced for treatment. As the condition progresses, some symptoms that may appear include:
Fatigue
Abdominal pain or discomfort
Nausea and/or vomiting
Yellowing of the eyes or skin (jaundice)
Enlarged liver
Confusion or difficulty thinking clearly
Abnormal weight loss
How is Fatty Liver diagnosed?
Given that fatty liver may not always cause symptoms, it can often go undiagnosed. Typically, it is discovered through tests for other health issues or can sometimes be seen in routine blood work. Elevated liver enzymes – AST and ALT – can be early signs of inflammation in the liver, however these enzymes can present within normal limits in fatty liver disease as well. Imaging modalities such as abdominal ultrasounds, CT scans, or MRIs can also detect increased fat content in the liver. A more precise imaging technique is a FibroScan, which is a specialized type of ultrasound used to measure the fat content and stiffness of the liver. In some cases, an even more invasive procedure such as a liver biopsy is needed to diagnose and assess the severity of fatty liver disease.
Implications of Fatty Liver
Fatty liver, especially in its early stages, is not always harmful and is relatively easy to manage through proper lifestyle and diet modifications. However, fatty liver can become dangerous if it progresses to inflammation and then to fibrosis or scarring of the liver tissue, otherwise known as Metabolic Dysfunction-Associated Steatohepatitis (MASH). MASH can further put a person at risk of developing metabolic conditions such as obesity, type two diabetes, and elevated cholesterol and triglyceride levels. Even more serious implications of fatty liver can include cardiovascular disease, cirrhosis, liver cancer (hepatocellular carcinoma), and even liver failure.
Treatment and Management for Fatty Liver
The liver is an incredible organ capable of regenerating itself, even after damage and inflammation. Therefore, fatty liver is largely reversible, especially in the early stages through proper lifestyle changes. The biggest contributing factors are:
Weight Loss
Losing 5-10% of body weight, through a gradual and sustainable process, can significantly reduce fat accumulation and inflammation in the liver. Avoid rapid weight loss as this can potentially harm the liver and lead to further fat accumulation. A rapid decline in weight can disrupt the liver’s natural process for burning fatty acids and fat stores, resulting in further buildup of fat in the liver.
Healthy Diet
Consider implementing a Mediterranean diet – focusing on whole foods such as fruits and vegetables. Foods high in healthy fats like avocados, nuts and seeds, olive and avocado oils are also recommended. Avoiding processed and packaged foods and eating proteins high in omega-3 fatty acids such as fish and seafood ca help support metabolic and heart health, as well as reduce inflammation.
Regular Exercise
Aiming for at least 150 to 240 minutes of exercise weekly, specifically aerobic activity, can tremendously improve fatty liver disease. Regular exercise improves insulin sensitivity and can lead to weight loss which reduces overall fat in the liver. Increased activity also has cardiovascular benefits and can help regulate hormones to improve overall health.
Limiting Alcohol Consumption
Even small amounts of alcohol can cause further damage to the liver, especially in those that already suffer from fatty liver disease. Limiting or abstaining from alcohol consumption is best practice to avoid progression of fatty liver.
Medications
Currently there are no medications on the market for fatty liver, but some medications for diabetes or cholesterol management, can help offer indirect benefits for fatty liver disease. Mitigating risk factors combined with the proper lifestyle changes is the most recommended treatment.
Prevention of Fatty Liver
What can you do if you suspect you may have fatty liver? Get regular check-ups and blood work done to keep an eye on liver enzymes, cholesterol levels, and blood sugar. If you have a combination of risk factors such as diabetes, obesity, high cholesterol or high blood pressure, getting a FibroScan done can help determine if you may have fatty liver. Besides diagnostic tests, maintaining a healthy diet and weight, incorporating regular exercise, and limiting alcohol and sugar are all great practices to keep your liver healthy.
Fatty liver disease is a rapidly growing global health issue, but it is also easily preventable and manageable with the right resources. While it often does not present symptoms in the early stages, if left undiagnosed and ignored, it can lead to inflammation and further damage of the liver. Early detection through routine testing and imaging paired with lifestyle changes can help to stop further progression and reverse the effects of fatty liver or avoid its onset altogether. If you think you may be at risk for fatty liver disease, talk to your healthcare provider. A few quick blood tests or even a FibroScan can give you peace of mind or help you take the necessary steps towards a healthier liver.
