Ask a GP: Understanding fatty liver disease
Monday, 13 July 2026
Fatty liver disease happens when too much fat builds up in your liver. Your liver normally has a small amount of fat, but when more than 5% of your liver cells contain fat, it's called fatty liver disease.
The most common type is called non-alcoholic fatty liver disease (NAFLD), which means it's not caused by drinking too much alcohol.
Fatty liver disease is closely linked to your overall metabolism and lifestyle. The main causes include:
Being overweight or obese – Extra body weight, especially around your belly, is the biggest risk factor
Type 2 diabetes or prediabetes – High blood sugar and insulin resistance contribute to fat buildup in the liver
High cholesterol or triglycerides – Abnormal blood fats can lead to liver fat accumulation
Poor diet – Eating too many calories, especially from sugar, high-fructose corn syrup (found in sodas and sweetened drinks), and saturated fats
Lack of physical activity – Not getting enough exercise makes it harder for your body to process fats properly
About 3 in 10 adults worldwide have fatty liver disease, and the numbers are rising.
Most people with fatty liver have simple fat buildup without liver damage. However, in some people, the disease can progress through these stages:
Simple fatty liver – Fat in the liver with no inflammation or damage
Steatohepatitis (NASH) – Fat plus inflammation and liver cell injury
Fibrosis – Scar tissue begins to form
Cirrhosis – Advanced scarring that can lead to liver failure
The good news is that not everyone progresses beyond simple fatty liver, and the condition can often be reversed with lifestyle changes.
Most people with fatty liver disease have no symptoms, especially in the early stages. It's often discovered during routine blood tests or imaging done for other reasons. Some people may experience:
Fatigue or feeling tired
Discomfort in the upper right side of the belly
Unexplained weight loss (in advanced stages)
The most effective treatment for fatty liver disease is lifestyle modification. There are currently no approved medications specifically for fatty liver, so healthy habits are your best tool.
Weight Loss
Losing just 5% of your body weight can reduce liver fat
Losing 7-10% can improve liver inflammation
Losing more than 10% may help reverse liver scarring in some people
Even modest weight loss makes a difference
Diet Changes
Reduce your overall calorie intake
Avoid or limit sugary drinks and foods with high-fructose corn syrup
Cut back on saturated fats (found in fried foods, fatty meats, and full-fat dairy)
Eat more vegetables, fruits, whole grains, and lean proteins
Limit or avoid alcohol completely
Exercise
Aim for at least 150 minutes of moderate activity per week (like brisk walking)
Exercise helps reduce liver fat even without weight loss
Both aerobic exercise (walking, swimming, cycling) and strength training are beneficial
Manage Related Conditions
Control your blood sugar if you have diabetes or prediabetes
Keep your cholesterol and blood pressure in a healthy range
Work with your doctor to manage any metabolic conditions
Bottom line
If you've been told you have fatty liver disease:
Talk to your doctor about your specific situation and whether you need additional testing
Set realistic goals for weight loss and lifestyle changes
Consider working with a dietitian or nutritionist for personalized dietary advice
Start incorporating more physical activity into your daily routine
Get regular follow-up with your healthcare team to monitor your progress
Remember, fatty liver disease is often reversible with consistent lifestyle changes. Small, sustainable changes are better than drastic diets that are hard to maintain long-term.