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Computer illustration of a solid red liver inside a blue outline rendering of a person's abdomen.
Computer illustration of a solid red liver inside a blue outline rendering of a person's abdomen.

Nonalcoholic Fatty Liver Disease: What to Know

Causes and Treatments

Over time, heavy drinking can lead to alcohol-related liver issues. However, liver issues can also arise in those who drink little or no alcohol. One of these issues is nonalcoholic fatty liver disease (NAFLD), which is a condition where extra fat accumulates in your liver.

Justin R. Boike, MD, a hepatologist at Northwestern Medicine, breaks down what you need to know about NAFLD.

Understand the Disease

Research suggests that you may be more likely to develop NAFLD if you are:

  • Overweight or obese
  • Insulin resistant or have Type 2 diabetes
  • Living with a metabolic syndrome or one or more traits of a metabolic syndrome

NAFLD typically does not have any symptoms. However, you may experience fatigue or discomfort in the upper right side of your abdomen.

There are two types of NAFLD:

  • Nonalcoholic fatty liver (NAFL) involves fat production in your liver but causes little to no inflammation or liver damage. This condition may cause pain, and it usually progresses to cause liver damage or complications.
  • Nonalcoholic steatohepatitis (NASH) causes liver inflammation and damage. Together, these can cause scarring or even cirrhosis. Cirrhosis can lead to liver cancer.

"In the United States, NASH is now one of the primary causes of cirrhosis and reasons for liver transplant," explains Dr. Boike. "Patients with NASH who have evidence of scarring in the liver are at risk for progression to cirrhosis."

In order to diagnose NAFLD, your care team may use blood tests, imaging tests or a liver biopsy. These measures also help determine if you have NAFL or NASH. Medical experts don't yet know why some people have NASH while others have NAFL.

Pursue Treatment

There is no medication to treat NAFLD, explains Dr. Boike. However, weight loss has been shown to be an effective treatment.

"General dietary recommendations include avoidance of high fructose corn syrup (such as soda and sweetened beverages) and limiting carbohydrates in the diet," Dr. Boike says. "The Mediterranean diet has also been shown to be beneficial, especially if patients have underlying metabolic syndrome." Weight loss can help fight fat buildup, inflammation and fibrosis in your liver.

Prevention is key. To help prevent NAFLD, stay physically active, eat a healthy diet and maintain a healthy weight. Connect with your care team if you have a hard time with any of these — they can help you make a plan that works best for you and your health goals.