Fatty liver disease is now one of the most common liver conditions in the world, affecting roughly one in three adults. In 2023, international liver societies renamed the most common type metabolic dysfunction-associated steatotic liver disease (MASLD), because it is closely linked to weight, blood sugar and cholesterol rather than alcohol.
Six months from now, you could have a healthier liver, more energy and lower blood sugar, from changes you start this week.
Why it matters
A fatty liver can become inflamed. Over years, inflammation can cause scarring (fibrosis), cirrhosis and, in some people, liver cancer. It also raises the risk of heart disease and type 2 diabetes.
Silent signs
Most people have no symptoms. It is often found by chance on a blood test or ultrasound. When symptoms happen, they may include:
- Tiredness
- Discomfort in the upper right of the abdomen
- Later signs of advanced disease: yellow skin or eyes, swelling of the legs or abdomen, easy bruising, confusion
Who is at risk?
- Overweight, especially fat around the waist
- Type 2 diabetes or prediabetes
- High blood pressure or high cholesterol
- Polycystic ovary syndrome
- Sleep apnoea
- Regular alcohol use (alcohol-related fatty liver is a separate but related condition)
How to reverse it
The liver can heal, especially early on. Research shows that losing around 7–10% of body weight can reduce liver fat and inflammation, and in some people improve scarring.
- Lose weight gradually, about 0.5–1 kg a week.
- Cut sugary drinks and foods high in added sugar and refined carbohydrates.
- Eat a Mediterranean-style diet: vegetables, legumes, whole grains, fish, nuts and olive oil.
- Move more: at least 150 minutes of moderate activity a week; it helps even without weight loss.
- Limit or avoid alcohol.
- Control diabetes, blood pressure and cholesterol.
Testing
Liver blood tests can be normal even with fatty liver. Health professionals may use an ultrasound, a fibrosis score calculated from blood tests, or a special scan (elastography) to check for scarring.
“But I barely drink, so how can I have a fatty liver?”
Most fatty liver today is linked to weight, blood sugar and diet, not alcohol. That is exactly why it was renamed metabolic dysfunction-associated steatotic liver disease.
Your next step: swap one sugary drink a day for water this week, and ask about a liver check if you have diabetes or carry weight around your waist.
Related: Liver cirrhosis nursing care · Early signs of diabetes
Sources: European Association for the Study of the Liver (EASL), AASLD and ALEH, 2023 multisociety nomenclature for steatotic liver disease; EASL-EASD-EASO clinical practice guidelines on MASLD (2024).
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