Fatty liver is usually found by accident — on an ultrasound done for something else entirely. Patients are often told not to worry about it. That advice is too casual.
Why it matters
Fat in the liver can progress to inflammation, then scarring, then cirrhosis. Non-alcoholic fatty liver disease is now among the fastest-growing reasons for liver transplantation worldwide. It is also an independent marker of cardiovascular risk — many of these patients will have a heart problem before they have a liver problem.
Who develops it
Not only people who are overweight. A significant number of lean Indians develop fatty liver because of visceral fat distribution, insulin resistance and a diet high in refined carbohydrates and fructose. Sweetened drinks, including packaged fruit juice, are a bigger contributor than most patients realise.
How we assess severity
Ultrasound tells us fat is present. FibroScan measures stiffness and tells us whether scarring has begun, which is the number that actually matters. Blood tests alone can be normal even with significant disease.
Treatment that works
- Losing 7–10% of body weight clears a large amount of liver fat
- 150 minutes of exercise a week, ideally including resistance training
- Cutting sugary drinks and refined carbohydrates before cutting fat
- Controlling diabetes, cholesterol and thyroid function
- Vitamin E or newer agents in selected biopsy-proven cases
The good news
Simple fatty liver, caught before scarring, is almost entirely reversible. The liver has a remarkable capacity to repair itself once the metabolic pressure comes off.
