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Fat accumulation inside the liver causes fatty liver disease, which can affect liver function. The disease usually starts without clear indications. If left untreated, the condition can progress to severe liver issues that may include tissue inflammation, fibrosis, or complete liver failure. Early detection and lifestyle changes can help patients control or reverse their progression. This blog will explore what causes fatty liver, who is at risk, and how to manage or treat it effectively.
Synopsis
What Causes Fatty Liver?
Fatty liver disease is the abnormal accumulation of fat in liver cells. It can occur with or without alcohol consumption. The liver stores fat, but its ability to store fat is limited. This condition occurs when fat accumulates in 5-10% of the liver's weight.
Here are some common factors that define what may cause fatty liver:
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Overeating and Weight Gain: When people consume excess calories, particularly sugary and fatty foods, the liver accumulates fat deposits.
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Insulin Resistance: When the body does not use insulin properly, more fat is stored in the liver cells.
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High Alcohol Intake: Excessive alcohol consumption can damage liver cells and create fat storage. It also disrupts the liver's function to metabolize and break down fat.
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Rapid Weight Loss: Losing weight too quickly can stress the liver and create temporary fat build-up from a biological process.
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Certain Medications: Some medications (steroids, tamoxifen, or chemotherapy drugs) could lead to fat build-up in the liver.
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Poor Gut Health: When bacteria in the gut are poorly balanced, there can be fat build-up in the liver, and the liver can also be stressed from poor digestion and increased toxin production.
Types of Fatty Liver Disease
There are 2 main types of Fatty Liver Disease - Non-Alcoholic Fatty Liver Disease and Alcoholic Fatty Liver Disease. This is mainly due to different lifestyles and health factors. However, let us see all the major types in detail:
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Fatty Liver Disease Types |
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Non-Alcoholic Fatty Liver Disease (NAFLD) |
This occurs in people with little to no alcohol consumption and is often due to reasons such as obesity, an unhealthy diet, and metabolic reasons such as diabetes and high cholesterol. |
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Alcoholic Fatty Liver Disease (AFLD) |
This form of liver disease is caused by heavy alcohol use. It is an earlier stage and is important to identify before it progresses to alcoholic hepatitis or cirrhosis. |
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Non-Alcoholic Steatohepatitis (NASH) |
Along with fat build-up in the liver, NASH is a more progressed version of NAFLD; an indication of inflammation and damage to liver cells. |
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Simple Fatty Liver (Steatosis) |
In this milder form, fat is present in the liver with no inflammation or damage to liver cells. |
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Acute Fatty Liver of Pregnancy |
This is present during the 3rd trimester of pregnancy. This is a serious condition that requires immediate medical attention. |
What Causes Fatty Liver? Common Risk Factors
While anyone can develop fatty liver, certain health conditions and lifestyle choices make some people more vulnerable than others. Knowing these risks can help you prevent or manage the condition early on.
Below are some of the most common causes of fatty liver disease:
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Obesity and Overweight: Excess body fat increases the risk of fat storage in the liver, especially around the stomach (belly fat).
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Type 2 Diabetes: People with diabetes are more likely to have insulin resistance than others, increasing fat levels in the liver.
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High Cholesterol and Triglycerides: Too much fat in the blood can accumulate in the liver and be stored in liver cells.
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Sedentary Lifestyle: Not getting enough exercise slows down your metabolism, making fat more likely to accumulate.
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Unhealthy Diet: Diets high in sugar, refined carbs, and processed foods promote fat storage in the liver over time.
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Polycystic Ovary Syndrome (PCOS): Women with PCOS often have insulin resistance, increasing the risk of NAFLD.
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Sleep Apnoea: Interrupted sleep affects how your body uses insulin and stores fat, adding pressure on liver function.
Fatty Liver Treatment
The good news is that fatty liver can often be reversed. The key is to treat the root cause, which most often is poor diet, weight, or alcohol use, and stick to long-term healthy habits. Here are the best fatty liver treatment strategies:
Lifestyle Modifications
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Weight Loss: Losing just 5 - 10% of body weight can significantly reduce fat in the liver and improve liver function.
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Healthy Diet: Eating more fruits, vegetables, lean proteins, and whole grains while avoiding sugar, alcohol, and processed foods helps reduce liver fat.
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Exercise: Daily, at least 30 minutes of physical activity boosts fat burning and insulin sensitivity.
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Avoid Alcohol: For people with AFLD or even NAFLD, cutting down on alcohol completely helps the liver heal and reduces inflammation.
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Control Blood Sugar: Managing diabetes through diet, exercise, or medication reduces fat build-up in the liver.
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Lower Cholesterol: Reducing bad cholesterol with diet or medications (like statins, if indicated and monitored by a doctor) helps prevent extra fat from building up in the liver. Take guidance from a doctor before taking any medications.
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High Blood Pressure: Effective management through lifestyle and medication is important.
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Counselling and Support Groups: This can help maintain alcohol abstinence (e.g., Alcoholics Anonymous, therapy).
Medical Interventions
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Opt for Liver-Friendly Medications: Only one medication - Resmetirom (Rezdiffra) has been FDA-approved specifically for the treatment of NASH (MASH) with moderate to advanced liver scarring (fibrosis). It works by activating a thyroid hormone receptor to reduce liver fat. In some cases, doctors may prescribe Vitamin E and insulin-sensitising drugs to reduce liver fat.
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Nutritional Support: Malnutrition is common in individuals with AFLD. A balanced diet and, in some cases, nutritional supplements or specialized feeding (e.g., via a feeding tube in severe cases) may be necessary.
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Corticosteroids: In severe cases of alcoholic hepatitis, corticosteroids are used to reduce liver inflammation and improve short-term survival. However, they have side effects and are not suitable for all patients (especially those with active infections, kidney failure, or GI bleeding).
Conclusion
Fatty Liver Disease is becoming more common around the world due to rising obesity rates and poor diet habits. While it may not cause symptoms early on, it can lead to severe liver damage if ignored. Thankfully, it is also one of the few liver issues that can be reversed with lifestyle changes. Eating healthy, losing weight, avoiding alcohol, and exercising regularly can make a huge difference.
Early diagnosis by an experienced gastroenterologist in Bangalore and the proper management steps can help you live a long, healthy life even with fatty liver.
FAQ's
Yes, early-stage fatty liver disease can often be reversed – the key to achieving optimal liver health is proper diet, weight loss, and exercise. Guidance from a gastroenterologist is crucial in managing your liver health if you’re at an increased risk of developing the disease.
It can be dangerous if not treated on time. Over the years, liver ailments may progress to inflammation, scarring, and even liver failure in severe cases, requiring immediate measures like a liver transplant.
If you have fatty liver, avoid consuming alcohol, fried foods, and sugary drinks. White bread and processed snacks also worsen liver fat and may progress to liver inflammation and cirrhosis with time.
Yes, people with normal weight or underweight can also develop fatty liver. This condition occurs mostly due to various lifestyle habits like poor diet, insulin resistance, or genetics.
At Manipal Hospital Whitefield, our doctors usually recommend blood tests and ultrasounds (USGs) to diagnose fatty liver. Sometimes, liver biopsies are also needed to check for liver inflammation or organ damage.
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