Fatty Liver Disease: What To Do
Fat accumulating in liver cells, now most often called metabolic dysfunction-associated steatotic liver disease.
Last revised
It is the commonest liver condition in the UK, usually symptomless, and largely reversible in its early stages.
Key takeaways
- Strongly associated with: excess weight, type 2 diabetes, high blood pressure, raised lipids
- Usually found: incidentally on blood tests or a scan
- Most useful single change: Aim for gradual weight loss; it reverses fat accumulation.
- Commonest mistake: Alcohol, which compounds the damage.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Aim for gradual weight loss; it reverses fat accumulation
- Increase physical activity, which helps independently of weight
- Treat diabetes, blood pressure and lipids, which drive progression
- Ask about fibrosis assessment, such as a FIB-4 score
Do not
- Alcohol, which compounds the damage
- Assuming normal liver blood tests exclude fibrosis
- Rapid crash dieting, which can worsen liver inflammation
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Strongly associated with | excess weight, type 2 diabetes, high blood pressure, raised lipids |
| Usually found | incidentally on blood tests or a scan |
| Progression | a minority develop inflammation, fibrosis and cirrhosis |
| Most effective intervention | weight loss, often around 7-10 per cent |
| Liver blood tests | can be normal despite significant disease |
Where to go next
- Fatty Liver Disease: A Practical Checklist
- Myths About Fatty Liver Disease, Checked Against the Guidance
- Fatty Liver Disease — the reference entry
- Alcohol-Related Liver Disease: What Published Guidance Supports
- The Evidence on Liver Function Tests, Without the Hype
When to get help
Seek urgent medical help for yellowing of the skin or eyes, vomiting blood, black tarry stools, swelling of the abdomen, or new confusion and drowsiness. See a GP for persistent fatigue, itching, or upper right abdominal discomfort.
Where this comes from
- NICE — Non-alcoholic fatty liver disease: assessment and management
- British Liver Trust — fatty liver
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.