Doctors typically suggest losing weight to treat nonalcoholic fatty liver disease (NAFLD). There are currently no approved medications for treating NAFLD and many cases require no treatment.

NAFLD is the result of excess fat in the liver that is unrelated to alcohol use. The disease can either be nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH).

NALF causes little or no inflammation in the liver and does not damage the liver on its own. It can cause some pain but typically occurs without any symptoms.

NASH develops with inflammation and liver damage, which may eventually lead to symptoms that include:

  • tiredness
  • weakness
  • weight loss
  • itching
  • web-like blood vessels under the skin
  • yellowing of the skin or eyes

People typically have NALF or NASH, but some people have both. NASH can become serious and cause permanent liver damage, which doctors call cirrhosis. In severe cases, people with NASH may require a liver transplant.

NAFLD can be a dangerous condition because it may worsen without detection due to a lack of symptoms. This article discusses what treatments are available for NAFLD and how to prevent it.

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Not all cases of NAFLD require medical treatment.

People with NAFLD without symptoms or medical problems from the condition may benefit from losing weight. Obesity is the main cause of NAFLD and leads to buildups of fat in the liver.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends losing at least 3-5% of body weight to reduce fat in the liver. Losing at 7-10% can reduce liver inflammation. However, rapid weight loss or an unbalanced diet can worsen liver damage.

The Centers for Disease Control and Prevention advise following a healthy weight loss approach, which involves gradual weight loss of around 1 or 2 pounds per week. They suggest the most effective approaches combine healthy eating with regular physical activity.

A doctor may suggest dietary changes that include:

  • limiting fat intake
  • replacing saturated and transfats with unsaturated fats
  • eating foods with a low glycemic index, which help to control blood glucose levels
  • avoiding foods that are high in simple sugars

The NIDDK suggests that physical activity alone is beneficial for NAFLD, even without weight loss. Other methods of treating NAFLD include:

  • lowering cholesterol and triglyceride levels
  • controlling diabetes
  • reducing blood pressure
  • limited over-the-counter drug use
  • avoiding aclohol consumption

There are currently no approved medicines for treating NAFLD. The liver damage may stop on its own or continue to worsen in people with NASH. Doctors may recommend taking medications to treat problems that contribute to NAFLD, such as blood thinners or diabetes medications.

Scientists are currently studying new ways of treating NAFLD, such as vitamin supplements or repurposed diabetes medications. However, the NIDDK highlights the importance of consulting with a doctor before trying these approaches. Some herbal remedies can worsen liver damage.

People who develop complications from NAFLD may require medical treatment. For example, a doctor may prescribe medications or surgery for people with cirrhosis. In severe cases, some people may require a liver transplant following liver failure or cancer.

The exact cause of NAFLD is still unclear, but most cases are due to obesity. Around 75% of people who are overweight have NAFLD and 90% of people with severe obesity. The rising rates of obesity in the United States are occurring with the incidence of NAFLD.

Around one- to two-thirds of people with type 2 diabetes also have NAFLD. The number of people with type 2 diabetes has also been increasing alongside NAFLD in the U.S..

Reducing the risk of obesity and type 2 diabetes could lower the risk of NAFLD. This is achievable by keeping a healthy weight, exercising regularly, and following a healthy diet.

Other factors that increase the risk of having NAFLD include:

  • middle aged or older
  • Hispanic or non-Hispanic white background
  • unhealthy cholesterol or triglyceride levels in the blood
  • taking corticosteroids and some cancer drugs
  • losing weight too quickly
  • infections, such as hepatitis C
  • high blood pressure

Some of these risk factors are unavoidable, such as being middle-aged or older. However, it is sometimes possible to reduce the risk for related problems by following a healthy lifestyle, such as high blood pressure.

Most NAFLD cases occur without symptoms or need for medical treatment from a doctor. Doctors may diagnose NAFLD from routine blood tests in treating or diagnosing another condition. In these cases, they may order medical imaging tests to check for liver inflammation and damage.

People who are overweight, obese, or have type 2 diabetes may benefit from seeing a doctor about their risk of NAFLD. An early diagnosis can prevent NASH from causing permanent liver damage and leading to further complications in the future.

NAFLD is the result of fat building up in the liver, typically in people who are obese or with type 2 diabetes. The condition can occur without symptoms or medical problems. However, other cases can lead to permanent liver damage or liver failure.

Doctors typically recommend losing weight to treat NAFLD. There are currently no approved medications for the condition. Leading a healthy lifestyle could reduce a person’s risk of developing NAFLD.

Definition & facts of NAFLD & NASH. (2021). https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts

Eating, diet, & nutrition for NAFLD & NASH. (2021). https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition

Fatty liver disease. (n.d.). https://medlineplus.gov/fattyliverdisease.html

Losing weight. (2020). https://www.cdc.gov/healthyweight/losing_weight/index.html

National diabetes statistics report, 2020. (2021). https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html

Nonalcoholic fatty liver disease. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease

Treatment for NAFLD & NASH. (2021). https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/treatment