Lifestyle changes are the primary treatment for fatty liver disease. However, medications including insulin sensitizers and lipid-lowering drugs can help to treat the disease.

There are two main types of fatty liver disease: alcoholic fatty liver disease and nonalcoholic fatty liver disease (NAFLD). As these names suggest, the disease can develop in people who consume alcohol and in people who do not.

Diagnosis and treatment at early stages may help reverse some liver damage and inflammation.

This article discusses fatty liver disease in more detail, including medications and current treatment options.

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The liver is an essential organ of the body that plays many important roles such as:

Fatty liver disease is a condition that leads to excessive storage of fat in the liver. The two types of this disease are NAFLD and alcoholic fatty liver disease.

NAFLD is the most common cause of liver disease in the United States, affecting 80–100 million people. It is not related to heavy alcohol use. Obesity is one of the main risk factors for NAFLD. There are two main types of NAFLD: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH).

Alcoholic fatty liver disease affects people who consume excessive amounts of alcohol. It can lead to alcoholic hepatitis and cirrhosis. According to the Centers for Disease Control and Prevention (CDC), approximately 29,505 people died as a result of alcoholic liver disease in 2020.

Fatty liver disease often does not present symptoms. However, a few possible symptoms of NASH are:

Serious cases of fatty liver disease can cause fibrosis and cirrhosis of the liver, which can lead to liver failure.

Learn more about the differences among NAFL, NAFLD, and NASH.

Lifestyle changes, including the pursuit of weight loss, are the main treatment approach doctors recommend for NAFLD. However, the following medications may also be effective against fatty liver disease:

Insulin sensitizers

Insulin resistance plays an important role in the development and progression of NAFLD. The results of randomized controlled trials suggest that insulin sensitizers — also called thiazolidinediones (TZDs) — are effective against NASH. Two common TZDs are pioglitazone and rosiglitazone.

However, doctors do not typically recommend TZDs for treating NASH because of the possible side effects, which include:

Lipid-lowering drugs

Lipid-lowering drugs help inhibit the production of cholesterol. Initial studies suggest that lipid-lowering drugs such as statins could be helpful in treating NAFLD. However, healthcare professionals do not recommend using statins to treat NAFLD or NASH until further research determines that they are effective for this purpose.

Randomized controlled trials have also suggested that the lipid-lowering drug ezetimibe may be effective for the treatment of fatty liver disease. However, it is not a standard treatment.

Pentoxifylline

Pentoxifylline may inhibit the progression of NAFLD. However, it can cause adverse effects such as nausea and vomiting. Further research is necessary before doctors may recommend it as a potential treatment for fatty liver disease.

Angiotensin receptor blockers

Several clinical trials have suggested that angiotensin II type 1 blockers may be effective in inhibiting the progression of NASH. A few of the common type 1 blockers are telmisartan, losartan, and valsartan.

However, these blockers may have blood pressure-lowering effects that limit their use, and doctors do not typically recommend using these medications for fatty liver disease.

Steroids

Corticosteroids may be effective in the treatment of alcoholic fatty liver disease. However, their long-term use can cause several side effects.

Current treatment options for fatty liver disease include:

Lifestyle changes

Doctors generally recommend certain lifestyle changes that can help treat and prevent fatty liver disease, including:

A 2020 review indicates that vitamin E supplementation may also help treat NAFLD in adults.

Surgery

Bariatric surgery may help improve NAFLD in people with obesity.

An older 2014 meta-analysis indicated that surgery could lead to an 82% improvement in NASH histology and a 66% improvement in fibrosis.

Liver transplantation

Liver transplantation is the only option for people with liver failure. The process is complex and depends on the availability of donors.

A liver transplant is usually the last resort. People must abstain from alcohol for 6 months before they can receive a transplant. Afterward, people need lifelong follow-up to prevent and manage possible complications.

Below are some of the most common questions and answers about fatty liver disease.

Can fatty liver be cured permanently?

Early diagnosis and treatment can help reverse fatty liver disease. When a doctor diagnoses fatty liver in the early stages, a person may be able to reverse the condition by losing weight or avoiding intake of alcohol.

What medications help with fatty liver?

No medications are currently approved for the treatment of fatty liver disease.

What is the main cause of fatty liver?

Fatty liver disease has two types: alcoholic fatty liver disease and NAFLD. The main cause of alcoholic fatty liver is excessive alcohol consumption, and the main cause of NAFLD is obesity.

Fatty liver disease is a condition that leads to fat buildup in the liver. The two most common risk factors for fatty liver disease are obesity and excessive alcohol intake.

Serious cases of fatty liver disease can cause fibrosis and cirrhosis, which can ultimately lead to liver damage and liver failure.

Currently, doctors recommend diet and lifestyle changes, including the pursuit of weight loss, to help manage fatty liver disease in the early stages. They may recommend surgery or liver transplantation for people with serious liver damage or liver failure.