Fatty Liver Disease: How You Can Slay This Silent Killer

Written by Reshma Pathare on Mon, 12 February 2024 — Fact checked by Blessing Ifunanya Maduelosi

Key Highlights

  • Fatty liver is caused by excessive accumulation of fatty lumps in the liver.
  • There are two types of fatty liver disease, viz. alcoholic and non-alcoholic.
  • An unhealthy diet leads to fatty liver by deposition of excessive fats in the liver, derived directly from the unhealthy foods.
  • Symptoms of fatty liver disease include yellowing of eye whites, loss of appetite, and swelling of feet, among others.

The liver, when healthy, has a smooth surface. When suffering from fatty liver disease, this organ has a sickening appearance, lumps of fat pushing against its surface from inside, like warts.

Fatty liver is so called because of the deposition of fat inside the liver, this disease is the first stage of liver trouble, and it can be of two types: alcoholic and non-alcoholic fatty liver disease (NAFLD).

Fatty liver disease progresses to hepatitis and then comes cirrhosis. The first two stages are reversible, the third is not. Cirrhosis may even lead to death.


Decoding fatty liver disease

Simply put, fatty liver disease is a health condition caused by the accumulation of excessive fats in the liver. Usually, a small amount of fat is stored in the liver. But, when more than 5% of the liver is composed of fat, the liver is said to be fatty.

In the initial stage, this does not alter the function of the liver as the body has mechanisms in place that allows the liver cells to regenerate.

However, over time the liver may degenerate. The excess fats lead to extra pressure on the liver, making it difficult to produce bile and remove toxins. This eventually leads to inflammation of the liver.

Usually, there are three stages through which a fatty liver disease progress:

  • Stage 1: Inflammation of the liver leading to tissue damage (steatohepatitis)
  • Stage 2: Formation of scar tissue in areas where the liver is damaged (fibrosis)
  • Stage 3: The scar tissue takes over healthy liver tissue, leading to cirrhosis. Cirrhosis is what leads to liver cancer and liver failure.

In the first two stages, the liver functions well despite the damage. In the third stage, things take a critical turn.

According to data:

  • Globally, around 4.5%-9.5% of the general adult population suffers from cirrhosis. Two of the three main factors for this cirrhosis are Alcoholic, and Non-Alcoholic Steato-Hepatitis (NASH).
  • Globally, around 20% of the people having NAFLD, suffer from NASH, which is an inflammatory form of NAFLD.

Non-Alcoholic Fatty Liver Disease

NAFLD is caused by a diet heavy in saturated fats and the person carrying an excessive amount of body fat.

  • Saturated fats put a lot of pressure on the liver. They’re found in food items like butter, beef, cream, bacon, as well as in foods that are deep-fried, processed, or contain high levels of artificial sweeteners.
  • Being overweight or obese leads to excessive intrahepatic triglycerides (IHTG), a condition medically known as steatosis. This condition can be with or without inflammation. Either way, prolonged burdening of the liver with IHTG can lead to Type 2 diabetes, cardio-metabolic abnormalities like hypertension, and cardiac diseases.
  • When the volume of IHTG reaches more than 5% of the liver’s weight, it is said to be the onset of fatty liver disease. As the IHTG starts shooting up, it skews the metabolism of lipoproteins, fatty acids, and glucose. This disrupts the liver’s metabolic activities, leading to a ripple effect on the health of several organs.
  • NASH, the sub-type of NAFLD, is of greater concern because it causes inflammation of the liver. If not treated in time, NASH can lead to fibrosis, cirrhosis, and liver cancer.

Alcoholic Fatty Liver Disease

This is caused when the liver is tasked with metabolizing excessive amounts of alcohol. Heavy drinking for many years or frequent binge-drinking over a shorter period puts a huge strain on the liver. This organ is primarily responsible for metabolizing ethanol, which is the main component of any alcoholic drink. The strain leads to scars and lesions, and other problems.

To begin with, excessive amounts of alcohol can lead to a rise in IHTG. That’s because more alcohol disrupts the ethanol oxidation process, and the hepatic lipid metabolism is messed up to the extent that the liver becomes a lipid-storing organ instead of a lipid-burning one.

Over time, these fat deposits can progress to inflammation, also because alcohol converts into formaldehyde, a toxic systemic inflammation-causing poison.

Without due intervention, an alcohol-burdened liver can suffer from various complications ranging from enlarged liver, enlarged spleen, fluid build-up in belly, alcoholic cirrhosis, alcoholic hepatitis, and liver failure.

Other causes of fatty liver

In very rare cases, a woman may develop acute fatty liver of pregnancy (AFLP). This is a genetic complication that arises in the third trimester of pregnancy. If it arises, imminent delivery of the child is the only way to treat the issue.

Surprisingly, malnutrition or eating disorders like anorexia can also lead to fatty liver disease. The sharp drop in food intake causes mitochondrial and metabolic dysfunction in the liver. Severely inadequate intake of proteins leads to reduction in plasma triglycerides and phospholipids, along with an increase in free fatty acids. Taken together, these factors lead to a fatty liver.

Symptoms of fatty liver disease

Quite often, fatty liver disease does not make itself obvious till it progresses to the stage of hepatitis and maybe even cirrhosis.

There are a few symptoms, which must be recognized and responded to without waiting.

They are:

- Pain in the upper-right side of the abdomen

- Yellowing of eye whites, nails, skin (could be a sign of jaundice)

- Water retention and swelling in the ankles and feet

- Loss of appetite for many days on end

- Nausea and vomiting

- Drastic weight loss

- Fatigue and sluggish mental state

The symptoms can more often manifest in:

- People eating an unhealthy diet full of saturated fats

- People drinking excessive alcohol

- Menopausal women developing visceral fats

- Overweight or obese people

- Older individuals

- Diabetes patients

- People with high cholesterol

- People experiencing chronic stress

- People taking certain medications

- People with genetic complications that affect the liver

- People with infections like Hepatitis C

Best diet for Non-Alcoholic Fatty Liver

Fats are essential to the human body for insulation of organs and as a storehouse of energy. However, excessive fats (especially, saturated fats) can mark the onset of fatty liver disease, even in people who are otherwise in good health.

Lifestyle management is the best way to reduce the deposition of fats in the liver in the early stages, while it’s still reversible.

Hence, dietary changes are the best way to salvage a non-alcoholic fatty liver.

  • An apt diet for reducing the burden on a fatty liver includes foods rich in vitamins, proteins, good carbohydrates, fiber, and natural sugars.
  • Avoid artificial sweeteners, processed foods, deep-fried foods, and refined foods, because all of these only put extra pressure on the liver, apart from increasing obesity.
  • Certain foods are particularly prescribed to prevent or repair a fatty liver. These include decaffeinated coffee, foods like walnut and flaxseed that are rich in Omega-3 acids, garlic, and cruciferous vegetables like broccoli.
  • While NAFLD develops in people who drink little to no alcohol, any individual with this condition has to completely stop drinking. A fatty liver is already overburdened by fat; it’s not in a position to deal with the additional fats from alcohol, however small the quantity. A person with NAFLD could return to their very limited alcohol consumption once the fatty liver disease has been reversed.

Can fatty liver cause cirrhosis?

Liver cirrhosis is one of the complications arising from both types of fatty liver disease. It happens after many years of having a fatty liver, but once it sets in, liver cirrhosis is irreversible.

Cirrhosis means scarring of the liver, which happens when the liver tries to repair itself after every injury inflicted on it. In the process, scar tissues get formed.

Beyond a certain level of scar tissue formation, it becomes increasingly difficult for the liver to carry out its functions; thus, the organ moves closer to liver failure.

Cirrhosis can be treated if detected in time, but its symptoms may not become very clear until the liver has already got very damaged. The likelihood of cirrhosis is very high in heavy alcohol drinkers, so they should proactively try to cut down on alcohol and, optionally, get a medical consultation about liver function, even if symptoms aren’t visible.

The symptoms of cirrhosis include the symptoms of fatty liver disease, and it may additionally manifest itself through mental confusion. The damaged liver may not be able to process all the food and beverage toxins, and those may reach the brain through the bloodstream.

You must see a doctor if you start noticing signs such as your skin/nails yellowing, a loss of appetite and/or fatigue, ankles/feet swelling and so on.

Treatment of fatty liver disease

Prevention is the best treatment for fatty liver disease, since the symptoms don’t show up until considerable damage is done to the liver.

In order to prevent fatty liver disease and the subsequent complications, it is best to do the following:

  • Eat healthy food enriched with vitamins, fiber, proteins
  • Use cooking techniques that require very little oil
  • Maintain a healthy physique via exercise to avoid accumulation of abdominal fat
  • Consume alcohol minimally or not at all
  • Tackle chronic stress that leads to inflammation
  • Pair healthy habits with a natural alternative to support liver health, such as taking milk thistle. The natural herb is scientifically proven to support good liver health with the following benefits: being an antioxidant, detoxification, nourishment of the liver

In short, the treatment for fatty liver disease is choosing the lifestyle that you should’ve had before developing the disease. If you make this lifestyle change, fatty liver disease can be reversed.

In rare cases, doctors may prescribe medications containing Vitamin E, or medicines to control conditions like diabetes and high triglyceride levels as part of the fatty liver treatment.


Fatty liver disease is a problem that can be treated and reversed with minimal medication, if diagnosed in time. You must not be complacent about taking cognizance of symptoms and getting a liver function test done.

It also takes a long time for fatty liver disease to become hepatitis (unless it’s viral hepatitis) and eventually cirrhosis. But if you don’t utilize this time to undo the damage, then cirrhosis and liver failure could become life-threatening.

Your liver health is largely in your own hands. The best gift you can give your liver is an active-living, healthy-eating, mentally-relaxing lifestyle that’s also perfect for your overall well-being.


Reshma Pathare

Reshma Kulkarni-Pathare has been a self-employed media professional since 1999. Starting off as a Freelance Journalist for Times of India Thane Plus, Reshma went onto write for more than 45 national and international publications including Times of India, New Woman, Femina, Indian Express, The Hindu, BBC Good Homes and many more. While her forte has been lifestyle writing, she is equally proficient in writing health articles. Her health articles have been published in Health International (Dubai), New Woman, Femina, and Mother & Baby.

Apart from being a journalist, Reshma also works as a copy-editor for self-publishing houses and academic journals.

She is an award-winning bi-lingual translator with more than 12 books published in her name.

She has been a Visiting Faculty Member for post-graduate department of mass media at MET College (Mumbai) and Welingkar WeSchool (Mumbai).

She has worked as a Consumer Marketing Insights Researcher for global organizations like CEB Iconoculture (USA) and Gartner (USA).

Consolidating her multifarious skills in the media, in 2021, Reshma launched her own boutique media agency called Talking Turkey Communications, which specializes in content writing, editing, and translation.

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Our team of experts frequently monitors developments in the health and wellness field, and we update our articles when new information becomes available.

Current Version

Feb, 12 2024

Written By

Reshma Pathare

Fact checked By

Blessing Ifunanya Maduelosi

Aug, 01 2023

Written By

Reshma Pathare

Fact checked By

Blessing Ifunanya Maduelosi