Senior Health How to Improve Fatty Liver Disease 5/28/2024 | By Howard LeWine, M.D. Question: I was surprised to learn that I have excess fat in my liver. My blood tests have never shown any problem with my liver, including liver tests just done last week. I hardly drink alcohol and I try to follow a healthy diet. What else should I do to improve fatty liver disease? Answer: Doctors call it nonalcoholic fatty liver disease (NAFLD). Diabetes and a high body weight are the main risk factors for all forms of fatty liver disease. In fact, about 75% of people with one or both of these conditions have some form of NAFLD. Most people with NAFLD have a type known as simple fatty liver, or steatosis — excessive fat buildup in the liver not caused by overuse of alcohol, medication side effects, or genetic disease. However, up to 20% of people with NAFLD develop inflammation in the liver known as nonalcoholic steatohepatitis (NASH). Left unchecked, this more dangerous form can progress into fibrosis (scarring) and potentially cirrhosis (severe scarring and liver damage). There are no specific FDA-approved medicines for any stage of NAFLD. Therefore, lifestyle modifications are the best approach to improve fatty liver disease. Because a majority of people with NAFLD are overweight or even obese, weight management is the No. 1 action people can take to avoid NAFLD and keep simple fatty liver from turning into NASH. Weight loss can also protect people from other health risks common in people with NAFLD, such as diabetes, high blood pressure, high cholesterol, and cardiovascular disease. If you are overweight, weight loss of roughly 5% of your body weight might be enough to decrease the fat in the liver. Losing between 7% and 10% of body weight can reduce the amount of inflammation and injury to liver cells, and it may even reverse some of the fibrosis. Target a gradual weight loss of 1 to 2 pounds per week. For people with diabetes and those unable to attain their goal weight, your doctor may recommend drugs known to induce weight loss, such as the GLP-1 agonist semaglutide (Ozempic, Wegovy). Keep in mind that normal-weight people also can get NAFLD. Where your body fat lies, especially inside the belly, is also a strong indicator of NAFLD risk. Although any diet that promotes weight loss helps NAFLD, a low-calorie Mediterranean-style diet is an excellent choice. This nutrition plan emphasizes fruits, vegetables, whole grains, legumes, nuts, and olive oil. Regular exercise, independent of weight loss, also can directly help limit fat buildup in the liver. An analysis in the October 2021 issue of Frontiers in Nutrition found that exercise can reduce fat throughout the body, and especially visceral fat, the more dangerous deep layer of fat associated with liver inflammation. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu. ©2024 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC. Read similar articles on Seniors Guide: Preventing Fatty Liver Disease Read More Howard LeWine, M.D. Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.