Fatty liver disease, medically known as Non-Alcoholic Fatty Liver Disease (NAFLD) or MASLD (Metabolic dysfunction-associated steatotic liver disease), happens when excess fat builds up in your liver—without alcohol being the cause. If left untreated, it can worsen into MASH (previously NASH), liver cirrhosis, or even liver cancer.
Around 25% of people globally have fatty liver disease. This silent liver condition is now one of the leading causes of chronic liver disease—even in children.
This guide will walk you through the most effective, science-backed treatment options, categorized into home, non-surgical, and surgical treatments, so you can take charge of your liver health today.
What is Fatty Liver Disease and How Does It Relate to NAFLD?
Fatty liver disease happens when fat builds up in the liver cells. A small amount of fat in your liver is normal. But when fat makes up more than 5% to 10% of the liver’s weight, it becomes a health concern.
NAFLD is the term used when this fat build-up isn’t caused by alcohol. It’s now the most common chronic liver condition in the world.
| Type | Description |
|---|---|
| NAFL (simple fatty liver) | Fat in liver without inflammation or damage |
| MASH (formerly NASH) | Fat + liver inflammation + damage |
| Cirrhosis | Long-term damage with liver scarring |
| Liver cancer | Final stage in rare, untreated cases |
How does NAFLD differ from alcoholic fatty liver disease (AFLD)?
Both NAFLD and AFLD involve fat buildup in the liver, but the causes are different:
- AFLD: Caused by heavy alcohol use
- NAFLD: Occurs in people who drink little or no alcohol
Even people who never touch alcohol can have a liver full of fat due to obesity and NAFLD, diabetes, poor diet, and lack of exercise.
What are the different stages of NAFLD?
NAFLD has stages:
- NAFL (Simple fatty liver) – Fat in liver, but no damage yet.
- Non alcoholic steatohepatitis (NASH) – Inflammation and liver cell damage begin.
- Fibrosis – Liver starts to scar.
- Cirrhosis – Severe scarring, liver stops working properly.
If ignored, it may even lead to liver cancer or failure.
How does fat accumulate in the liver in people who don’t drink alcohol?
It usually starts with poor diet and insulin resistance and liver changes:
- Excess sugar and carbs turn into fat
- Body stores fat in the liver
- Liver cells get stressed, causing liver inflammation
The result? A liver full of fat in people who never drank a drop—purely because of metabolism.
Fatty Liver Causes
There is little known about this Non-alcoholic fatty liver disease. It is still unknown about the exact cause of the disease. Fatty liver causes are seen in some people, but not all; it is still unanswered.
NAFLD and NASH are both linked to the following conditions:
- Overweight or obesity
- Insulin resistance: This condition lets your body cells take up sugar in response to the hormone insulin.
- High blood sugar (hyperglycemia): This condition indicates pre-diabetes or type-2 diabetes
These various health problems lead to promoting the deposit of fat in the liver. In some people, this excess fat deposition acts as a toxin to liver cells. Therefore, this condition is the cause of liver inflammation and NASH. Scar tissue in the liver is built-up due to this condition.
Non-alcoholic Fatty Liver Disease Symptoms
Non-alcoholic fatty liver disease or NAFLD usually shows no symptoms or any signs of the disease. Just like the fatty liver causes are not known, the symptoms are also not clear.
But when the condition occurs, it includes:
- Fatigue
- Pain or discomfort in the upper right abdomen
Some visible signs and symptoms of NASH and advanced scarring (cirrhosis) include:
- Abdominal swelling (ascites)
- Enlarged blood vessels just beneath the skin’s surface
- Enlarged spleen
- Red palms
- Yellowing of the skin and eyes (jaundice)
The Risk Factors of Fatty Liver Causes
The conditions that increase the risk of NAFLD includes:
- High cholesterol
- High levels of triglycerides in the blood
- Metabolic syndrome
- Obesity, the condition related to the disposition of fat in the abdomen
- Gastric bypass surgery
- Polycystic ovary syndrome (PCOS)
- Sleep apnoea
- Type 2 diabetes
- An underactive thyroid (hypothyroidism)
- Underactive pituitary gland (hypopituitarism)
NASH is more commonly seen in these people:
- Over the age of 50
- People with smoking habits
- People with diabetes
- People with body fat concentrated in the abdomen
Most people show no symptoms. Although, in rare cases, people may experience fatigue, pain, or weight loss. People may also complain of inflammation and scarring of the liver (cirrhosis).
The 4 Stages of NAFLD Development
Most people during the first stage of the disease may not even realize it. In some cases, this liver condition can progress and eventually lead to liver damage if not diagnosed and treated.
The main stages of NAFLD include:
Simple fatty liver (steatosis): This condition can be diagnosed during tests carried for any other reason. In this stage, there is a largely harmless build-up of fat in the liver cells.
Non-alcoholic Steatohepatitis (NASH): This condition is the more serious form of NAFLD. This condition causes the liver to become inflamed.
Fibrosis: In this condition, the liver functions normally. But persistent inflammation causes scar tissue around the liver and nearby blood vessels.
Liver Cirrhosis: This is the most severe stage. This results after years of inflammation. This condition causes the liver to shrink and becomes scarred and lumpy. Cirrhosis of the liver is permanent damage. The condition can lead to liver failure, where your liver stops working properly. It may also lead to liver cancer.
Non-alcoholic Fatty Liver Disease Diagnosis
The diagnosis can be made after a blood test. It is known as the liver function test. The test shows abnormal liver conditions.
However, blood tests are not always sufficient to detect NAFLD.
Therefore, the condition can also be spotted by an ultrasound scan of the stomach. The scan is based on sound waves to create an image of the inside of the body.
If the diagnosis is positive and the person is suffering from NAFLD, further tests are done to determine the disease’s exact stage.
The stage can be detected by undergoing a special blood test. It can also be known through the Fibro scan. This is another type of ultrasound scan.
A biopsy is also another method for the detection of NAFLD. In a biopsy, a small sample of liver tissue is taken using a needle. The sample is sent to the path-labs to be analyzed.
It is also advised that children and young age group people suffering from type 2 diabetes or metabolic syndrome should have an ultrasound scan of their liver every 3 years.
| Test | Purpose |
|---|---|
| Blood Tests | Check liver enzymes (ALT/AST) |
| Ultrasound | Detect fat in the liver |
| Fibroscan or MRI Elastography | Assess liver stiffness and scarring |
| Liver Biopsy | Confirms MASH and cirrhosis |
Non-alcoholic Fatty Liver Disease Treatment
Most of the people with NAFLD may not show any signs of serious problems. But if the diagnosis is made, it is better to take some steps to get cured, unless the condition may get worse if left without any treatment.
There is no such specific medication to treat NAFLD. But a healthy lifestyle can help to avoid the disease.
What are the Home Treatments for Fatty Liver Disease?
Lifestyle changes have the most proven effect in reversing fatty liver disease.
| Lifestyle Change | How It Helps |
|---|---|
| Lose 7–10% body weight | Reduces liver fat, inflammation, and fibrosis |
| Eat Mediterranean-style meals | Includes olive oil, fish, veggies, whole grains |
| Avoid sugar and processed food | Reduces insulin resistance |
| Exercise 30–45 mins/day | Lowers fat in liver even without weight loss |
| Avoid alcohol completely | Alcohol adds more burden on liver |
| Sleep 7–8 hrs/night | Poor sleep raises cortisol and liver fat |
Bonus: Breastfeeding helps reduce fatty liver in mothers and lowers risk in children
Read: Heal Your Liver Naturally: Top Supplements for Fatty Liver
Medication for The Diseases
Medicines are recommended to treat the associated conditions such as high blood pressure, cholesterol, diabetes, and obesity.
| Medication | Use |
|---|---|
| Pioglitazone | Used in diabetics, improves liver fat and inflammation |
| Vitamin E | Antioxidant; useful in non-diabetics with MASH |
| GLP-1 receptor agonists (e.g. Semaglutide) | Diabetes/obesity meds showing promising results |
| SGLT2 inhibitors | Help with diabetes and reduce liver fat |
Always consult your hepatologist before starting any of these, some are not yet FDA-approved for fatty liver.
Liver Transplant
Treatment of Non-alcoholic Fatty Liver Disease in adults can be done through a liver transplant.
The liver stops working properly in patients suffering from severe liver cirrhosis. A liver transplant is recommended to those adults.
Adults can wait for a time frame of 135 days on average for a liver transplant from recently deceased donors.
A liver transplant is also possible using a section of the liver removed from a living donor.
As the liver has the capacity to regenerate itself, both the transplanted section of the person as well as the remaining section of the donor’s liver is able to regrow to normal size.
| Surgical Option | Use |
|---|---|
| Bariatric (weight loss) surgery | Recommended if BMI >35 with MASH or diabetes |
| Liver Transplant | Final option for end-stage liver failure or cancer |
Prevention of NAFLD
Non-alcoholic Fatty Liver Diseases can be prevented by taking some measures:
Following a Healthy Diet: Choose a healthy diet composed of vitamins, minerals, and protein. Avoid junk food and oily food. A plant-based diet is suggested for a healthy liver.
Maintain Body Weight: Make sure the body mass index (BMI) is at the required level. Measure it and reduce weight if you are overweight. Obesity may lead to several diseases.
Exercise: Workout is crucial to stay fit and healthy. Prepare a diet chart and also a workout plan for a healthy body.
Avoid Alcohol: Avoid alcohol and also reduce the consumption of tobacco for a healthy liver.
| Tip | Why It Works |
|---|---|
| Stick to 10% weight loss | Keeps liver fat away |
| Avoid sugar & sugary drinks | Lowers triglycerides |
| Stay active 5 days/week | Burns fat and improves insulin sensitivity |
| Check cholesterol, BP, blood sugar regularly | Controls metabolic syndrome |
| See your doctor every 6–12 months | Catch issues early |
Book a Consultation with Dr. Nivedita Pandey
Dr. Nivedita Pandey MBBS, Diplomate, American Board (Internal Med & Gastroenterology), is a US-trained Senior Consultant Gastroenterologist and best Hepatologist in India, and an obesity specialist. She specializes in:
- Fatty liver & NASH
- Liver transplant care
- Hormonal and digestive issues in women
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Schedule your appointment today to start reversing your fatty liver disease naturally and safely.
FAQs
Is fatty liver dangerous if left untreated?
Yes, untreated fatty liver disease can silently progress to more severe forms like non alcoholic steatohepatitis (NASH), liver fibrosis, and even cirrhosis. In some cases, it may lead to liver cancer. That’s why early screening and medical advice are essential.
Can thin people get NAFLD?
Absolutely. Fatty liver disease isn’t limited to people with obesity. Even thin individuals can develop NAFLD due to genetics, poor diet, or metabolic issues. This is called “lean NAFLD” and needs medical attention like any other case.
How long does it take to reverse fatty liver naturally?
If caught early, reversing fatty liver is possible within 3 to 6 months through consistent lifestyle changes. These include weight loss, daily physical activity, and a NAFLD diet rich in liver-friendly foods. Results depend on discipline and early intervention.
Does NAFLD always progress to cirrhosis?
Not always. Many people stabilize or reverse early-stage NAFLD with proper care. But if ignored, it can silently move from fatty liver disease to liver cirrhosis stages. That’s why timely checkups and early treatment are crucial.
Is NAFLD common in India?
Yes. Studies from ICMR and WHO report that about 25–35% of urban Indians have fatty liver disease, often without symptoms. With the rise in metabolic syndrome, this number is growing steadily.
Is fatty liver disease painful?
In early stages, most people feel nothing. As liver inflammation or scarring worsens, you may feel dull pain in the upper right abdomen. Swelling, fatigue, and other symptoms can appear in advanced stages. Always consult a liver specialist if unsure.