What is fatty liver disease?


The liver is the second largest organ in the body. It helps us absorb nutrients and is an essential filter for our blood, removing substances that could harm us. We cannot live without a liver.

Small amounts of fat in the liver are normal. However, when the body produces too much fat or doesn’t metabolize fat efficiently, it may be stored in liver cells, creating excess fat in the liver.

There are two types of fatty liver disease:

  • Alcoholic fatty liver disease (AFLD) – develops in someone who drinks an excessive amount of alcohol
  • Non-alcoholic fatty liver disease (NAFLD) – develops in someone who does not drink an excessive amount of alcohol

Too much fat buildup can cause unhealthy inflammation and affect the organ’s ability to function properly. This may cause swelling, scarring and, in extreme or serious cases, damage which can lead to cirrhosis of the liver, liver cancer, or liver failure.

There are four stages of fatty liver disease:

  1. Fatty liver disease or Steatosis – the buildup of excess fat
  2. Steatohepatitis – excess fat plus the presence of inflammation
  3. Fibrosis – abnormally large amount of scar tissue
  4. Cirrhosis – scarring of the liver is widespread, possibly irreversible and life-threatening

What are the causes and risk factors for fatty liver diseases?

There are more than three million cases of fatty liver conditions reported in the United States each year.

AFLD is caused by a high volume and frequent intake of alcohol, particularly in those who struggle with an alcohol use disorder, resulting in the accumulation of fat around the liver.

A family history of AFLD, episodes of heavy or binge drinking, and poor nutrition can also lead to an increased risk of developing fatty liver disease.

Causes of NAFLD–found in individuals who do not drink excess alcohol–are less obvious and still under investigation and research.

There seems to be a correlation between fatty liver disease and those individuals with:

  • Metabolic syndrome (insulin resistance, high blood pressure, high cholesterol and triglycerides)
  • Obese or overweight body mass indexes (BMI)
  • Type 2 diabetes
  • Certain prescription medications (amiodarone, diltiazem, tamoxifen or steroids)
  • Family history/genetic disposition
  • Obstructive sleep apnea

There may be a connection to exposure to certain toxins, medications, or infections, or a relationship to conditions like pregnancy, polycystic ovary syndrome, or rapid weight loss. Additionally, Hispanic or Asian populations and postmenopausal women appear to have a greater chance of developing fatty liver disease.

What are the symptoms of fatty liver disease?

Some people with fatty liver disease have no symptoms, particularly in the early stages, while advanced cases – closer to developing cirrhosis – are more likely to see and feel signs.

Those with lower levels of damage may experience fatigue and discomfort or pain in the upper right side of the abdomen.

More common as the condition worsens, individuals may experience yellow skin and eyes, weakness, nosebleeds, confusion, itchy skin, web-like clusters of blood vessels under the skin, and more.

These symptoms point to possible presence of cirrhosis, which can be life-threatening, and should be addressed with a medical provider as soon as possible.

Doctors may be the first to spot fatty liver disease, even with no symptoms, if patients present elevated liver enzymes on blood tests.

How to treat fatty liver disease?

For those in early stages of both AFLD and NAFLD, the great news is there are ways to help reverse the disease and return to a healthier liver function.

Treatment plans often include limiting or avoiding alcohol, making lifestyle changes to lose weight, and adjusting diet.

Individuals may be asked to limit certain types of fats and carbohydrates while incorporating more plant-based foods and managing overall calorie intake.

For those with complications, primarily those who have developed cirrhosis, additional treatments like medications and surgeries may be recommended.

If the disease has progressed to liver failure, a patient may require a liver transplant.

Working with a medical professional at the early stages of fatty liver disease helps to stop the progression of scarring that may cause permanent damage and also helps individuals regain and maintain healthy liver function.

It is vital that those with early signs take immediate steps to protect the liver since it is an essential organ that we can’t live without.

A primary care physician can review medical history, current health status, and test results to help individuals create plans and lifestyle changes to address fatty liver disease and reverse the condition.

At UPMC Western Maryland, general practitioners are available at a variety of locations. Don’t delay; make an appointment today with a primary care provider and begin the journey to better health.

Click here for a full list and contact information for UPMC Western Maryland’s primary care centers: