As the name suggests, fatty liver disease occurs when too much fat builds up inside the liver. While it's often linked to excessive alcohol consumption, this is not always the case. Fatty liver disease can also be linked to underlying health conditions, including diabetes or obesity.
If you have fatty liver disease, you might wonder if this condition is reversible. Unfortunately, there are no medications currently available to treat this condition. However, there are several promising lifestyle changes proven to help.
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When too much fat accumulates in the liver, this is known as fatty liver disease.¹ There are two types of fatty liver disease.
Alcoholic fatty liver disease (also called alcoholic steatosis). When this progresses to be associated with inflammation, this is called steatohepatitis.
Nonalcoholic fatty liver disease (NAFLD)
Alcoholic fatty liver disease is related to heavy alcohol consumption. The liver is the primary organ responsible for clearing alcohol from the body.
As the liver breaks down alcohol, harmful compounds can accumulate inside it. These compounds damage the liver, causing inflammation and damage to tissues in the liver.
Alcoholic fatty liver is an early sign of alcohol-related liver disease. If you do not reduce your intake of alcohol, you could go on to develop alcoholic steatohepatitis and cirrhosis.
NAFLD is a fatty liver disease not associated with alcohol consumption. There are two types of NAFLD: simple fatty liver and nonalcoholic steatohepatitis (NASH).
Simple fatty liver is when your liver has minimal inflammation or cell damage. It tends to be milder, with fewer complications.
In contrast, NASH causes a greater degree of inflammation and cell damage in the liver. As a result, it may result in fibrosis or scarring, which could then lead to cirrhosis or liver cancer.
All types of fatty liver disease have very few symptoms. In some cases, there might be no apparent symptoms at all.
However, some symptoms you may notice are:
Fatigue and tiredness
Discomfort in the upper side of your abdomen
Alcoholic fatty liver is caused by excessive consumption of alcohol over a long period. However, you are more at risk of developing alcoholic fatty liver if you are a smoker, have another liver disease such as chronic viral hepatitis, or are obese.
Because alcohol is the primary cause of alcoholic fatty liver, you should cut back on alcohol as much as possible to try and reverse this condition. On the other hand, there is no apparent cause for NAFLD, but the main pathophysiology seems to stem from insulin resistance.² However, there are several risk factors that could make you more susceptible to developing it.
These risk factors include:
Diabetes and insulin resistance
Having high levels of cholesterol and triglycerides (fats) in your blood
High blood pressure
Older age (>50y)
Unfortunately, there is no current treatment available for fatty liver disease. However, there are plenty of lifestyle modifications that you can try.
The most important way to reverse fatty liver disease is weight loss. Weight loss should be gradual (1–2 lbs per week), and improvements have been demonstrated in patients losing as little as 5% of total body weight. But >10% weight loss is associated with improvement in all aspects of NASH, including fibrosis.
A weight reduction diet is suitable for anyone who can't exercise adequately. However, you should also combine a weight reduction diet with moderate exercise.
Avoiding alcohol, or at least avoiding heavy alcohol use, is considered one of the most effective ways to reverse fatty liver disease. However, if you cannot avoid alcohol entirely, you should still make some effort to cut back as much as possible.
If you find it difficult to avoid alcohol, you could try medications such as disulfiram, acamprosate, or naltrexone.
Introducing a range of healthy foods into your diet can help reverse fatty liver disease for many reasons. Healthy eating can improve cholesterol, reduce obesity, and help with diabetes. As mentioned earlier, these are three risk factors for fatty liver disease.
Therefore, it's highly recommended to:
Avoid calorie-rich foods
Avoid foods with a high glycemic index (foods that are high in sugars)
Replace saturated and trans fats with unsaturated ones
Ultimately, a diet rich in fresh fruit and vegetables, as well as fiber and omega-3 polyunsaturated fatty acids, is recommended. Sugar-sweetened beverages and highly processed foods should be avoided. Therefore, incorporating a healthier diet into your lifestyle could help to reverse fatty liver disease.
Experts also suggest physical exercise is good for cardiorespiratory fitness, and exercise is associated with reduced liver fat even without weight loss.
Unfortunately, there is no exact guideline for how long fatty liver reversal may take. It ultimately depends on how well you can adjust to new lifestyle habits and whether they work for you.
For example, suppose you are using weight loss as a method for fatty liver reversal. In that case, you may notice significant results after losing weight.
But the important thing is to allow yourself enough time for the results to happen, as quite often, quick weight loss methods don't have lasting results.
These changes could also improve general health and well-being within the first weeks. Therefore, it's good to reflect upon how these changes will help your liver and improve your overall quality of life.
While there are some medications for fatty liver disease (including vitamin E and insulin sensitizers), the treatment options are limited. However, lifestyle changes are a simple reversal process you can try. These changes include avoiding alcohol, managing weight, and exercising. But if you notice that the symptoms of your disease are worsening, you should mention this to your doctor.
With early intervention, you might be able to reverse fatty liver completely. However, even if you can't reverse it entirely, you can still have significant improvements from various lifestyle changes.
A healthy diet that limits alcohol, unhealthy fats, sugars, and calorie-dense foods will help. However, you may notice better results by incorporating additional lifestyle changes.
Again, the time depends on how long it takes you to cut back on alcohol. If you use medications to fight alcohol cravings, you may notice the results sooner with this additional help.
There aren't many signs or symptoms of liver damage associated with fatty liver disease. However, some people notice increased fatigue and discomfort in the upper side of their abdomen.
Fatty liver disease | MedlinePlus
Fatty liver disease | MedlinePlus
Eating, diet, & nutrition for NAFLD & NASH | NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Selecting a weight-loss program | NIH: National Heart, Lung, and Blood Institute