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| {{Short description|Fatty liver disease, insulin resistance, ketogenic diet, and W8MD medical weight loss}}
| | #REDIRECT [[Fatty liver]] |
| [[File:NAFLD-prevalence-2019.svg|thumb|right|350px|[[Fatty liver disease]] is common worldwide and is strongly associated with [[insulin resistance]], [[obesity]], [[prediabetes]], [[type 2 diabetes]], and [[metabolic syndrome]].]]
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| [[File:NAFLD liver progression.svg|thumb|right|350px|Progression of [[fatty liver disease]] may include simple steatosis, steatohepatitis, fibrosis, cirrhosis, and liver failure.]]
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| [[File:Non-alcoholic fatty liver disease1.jpg|thumb|right|350px|[[Metabolic dysfunction-associated steatotic liver disease]] is closely linked to [[insulin resistance]] and excess liver fat.]]
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| [[File:MRI Liversteatosis.jpg|thumb|right|350px|Imaging tests such as [[ultrasound]], [[MRI]], or [[FibroScan]] may help evaluate fatty liver and liver fat content.]]
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| [[File:Stage of liver damage.JPG|thumb|right|350px|Untreated fatty liver disease may progress to inflammation, fibrosis, cirrhosis, and liver-related complications.]]
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| [[File:W8md weight loss sleep and medspa team.jpeg|thumb|right|350px|[[W8MD Weight Loss, Sleep and MedSpa]] physicians can help address the insulin resistance that drives fatty liver, prediabetes, PCOS, metabolic syndrome, and type 2 diabetes.]]
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| [[File:W8md-meal-replacementnts.png|thumb|right|350px|W8MD may use [[low-carbohydrate diet]] planning, [[ketogenic diet]] support, [[meal replacements]], [[protein]] goals, and medical weight loss tools to reduce liver fat.]]
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| {{Infobox medical condition
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| | name = Fatty liver disease
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| | synonyms = Hepatic steatosis, fatty liver, NAFLD, NASH, MASLD, MASH
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| | image = NAFLD liver progression.svg
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| | caption = Fatty liver disease may progress from simple liver fat to inflammation, fibrosis, cirrhosis, and liver failure
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| | field = [[Hepatology]], [[endocrinology]], [[obesity medicine]], [[internal medicine]], [[nutrition]], [[bariatric medicine]]
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| | symptoms = Often none; fatigue, right upper abdominal discomfort, elevated liver enzymes
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| | causes = [[Insulin resistance]], [[obesity]], excess refined carbohydrates, sugar-sweetened drinks, fructose, [[prediabetes]], [[type 2 diabetes]], [[metabolic syndrome]], alcohol in alcohol-related disease
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| | risks = [[Prediabetes]], [[type 2 diabetes]], [[PCOS]], [[metabolic syndrome]], [[hypertriglyceridemia]], [[hypertension]], [[sleep apnea]], [[obesity]]
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| | diagnosis = Liver enzymes, [[ultrasound]], [[FibroScan]], [[MRI]], fibrosis scores, blood tests, liver biopsy in selected cases
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| | treatment = [[Weight loss]], [[low-carbohydrate diet]], [[ketogenic diet]] in selected patients, exercise, treatment of insulin resistance, GLP-1 therapy when appropriate, fibrosis monitoring
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| | related = [[Insulin resistance]], [[metabolic syndrome]], [[prediabetes]], [[type 2 diabetes]], [[PCOS]], [[W8MD Weight Loss, Sleep and MedSpa]]
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| }}
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| [[File:Acanthosis-nigricans-2.jpeg|Acanthosis-nigricans|350px|right]]
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| [[File:Before-and-after-weight-loss.jpeg|Before and after weight loss|350px|right]]
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| '''Fatty liver disease''' is a condition in which excess fat accumulates inside [[liver]] cells. The modern term for the most common non-alcohol-related form is '''[[metabolic dysfunction-associated steatotic liver disease]]''' or '''MASLD''', formerly called '''[[nonalcoholic fatty liver disease]]''' or '''NAFLD'''. When liver fat is accompanied by inflammation and liver-cell injury, the condition may be called '''[[metabolic dysfunction-associated steatohepatitis]]''' or '''MASH''', formerly called '''[[nonalcoholic steatohepatitis]]''' or '''NASH'''.
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| The most important underlying cause of fatty liver in most patients is not simply “eating fat.” The central problem is usually '''[[insulin resistance]]'''. Insulin resistance causes the body to produce higher levels of insulin, which promotes fat storage, increases liver fat production, worsens [[triglyceride]] levels, and drives the metabolic problems that lead to fatty liver. Excess refined carbohydrates, sugar, fructose, sweetened drinks, white flour, large starch portions, and ultra-processed foods can worsen insulin resistance and increase the liver’s production of fat through [[de novo lipogenesis]].
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| For this reason, fatty liver is best understood as a metabolic disease closely related to [[prediabetes]], [[type 2 diabetes]], [[PCOS]], [[metabolic syndrome]], [[obesity]], [[sleep apnea]], high triglycerides, and abdominal weight gain. The 2024 EASL-EASD-EASO guideline describes MASLD as a metabolic condition and recommends case-finding in people with cardiometabolic risk factors, especially [[type 2 diabetes]], obesity, abnormal liver enzymes, or radiologic evidence of steatosis.{{cite journal|title=EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease|journal=Journal of Hepatology|year=2024|pmc=11299976}}
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| '''[[W8MD Weight Loss, Sleep and MedSpa]] Centers''' can help patients with fatty liver by targeting the root metabolic cause: insulin resistance. W8MD physicians can help patients lose weight, reduce carbohydrate overload, improve insulin sensitivity, screen for prediabetes and metabolic syndrome, evaluate sleep apnea, and use evidence-based tools such as [[low-carbohydrate diet]]s, [[ketogenic diet]]s when appropriate, [[meal replacements]], [[GLP-1 weight loss]] medications when appropriate, and long-term [[weight maintenance]].
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| ==Terminology==
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| The terminology for fatty liver disease has changed in recent years.
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| {| class="wikitable"
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| ! Older term
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| ! Newer term
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| ! Meaning
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| |-
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| | [[NAFLD]]
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| | [[MASLD]]
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| | Metabolic dysfunction-associated steatotic liver disease
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| |-
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| | [[NASH]]
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| | [[MASH]]
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| | Metabolic dysfunction-associated steatohepatitis
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| |-
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| | Fatty liver
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| | Hepatic steatosis
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| | Fat buildup in liver cells
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| |}
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| The newer terms emphasize the metabolic cause of the disease and reduce the focus on what the patient does not do, such as “non-alcoholic.”
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| ==Types of fatty liver disease==
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| Fatty liver disease may be divided into several categories:
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| {{div col|colwidth=18em}}
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| * [[Metabolic dysfunction-associated steatotic liver disease]]
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| * [[Metabolic dysfunction-associated steatohepatitis]]
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| * [[Alcohol-related fatty liver disease]]
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| * Mixed metabolic and alcohol-related steatotic liver disease
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| * Medication-induced fatty liver
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| * Pregnancy-related fatty liver disease
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| * Fatty liver related to rapid weight loss or malnutrition
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| {{div col end}}
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| ==Fatty liver and insulin resistance==
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| '''[[Insulin resistance]]''' is the central metabolic abnormality behind most cases of MASLD. In insulin resistance, the liver, muscle, and fat cells do not respond normally to insulin. The pancreas then produces more insulin to keep blood glucose under control.
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| High insulin levels contribute to fatty liver by:
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| {{div col|colwidth=18em}}
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| * Increasing liver fat production
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| * Promoting [[de novo lipogenesis]]
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| * Increasing [[triglyceride]] synthesis
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| * Blocking normal fat oxidation
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| * Increasing abdominal fat storage
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| * Worsening hunger and cravings
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| * Promoting [[prediabetes]]
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| * Promoting [[type 2 diabetes]]
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| * Worsening [[metabolic syndrome]]
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| {{div col end}}
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| This explains why fatty liver commonly occurs with:
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| {{div col|colwidth=15em}}
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| * [[Abdominal obesity]]
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| * [[Prediabetes]]
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| * [[Type 2 diabetes]]
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| * [[PCOS]]
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| * [[Acanthosis nigricans]]
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| * [[Metabolic syndrome]]
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| * [[High triglycerides]]
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| * [[Hypertension]]
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| * [[Sleep apnea]]
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| {{div col end}}
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| ==Why fatty liver is not simply caused by fat in the diet==
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| Although the disease is called “fatty liver,” the fat in the liver is not simply caused by eating dietary fat. In many patients, the liver makes fat internally from excess carbohydrate and sugar intake, especially when insulin resistance is present.
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| Important dietary drivers include:
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| {{div col|colwidth=15em}}
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| * Sugar-sweetened beverages
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| * Fruit juice
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| * High-fructose foods
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| * Sweetened coffee drinks
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| * Candy
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| * Pastries
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| * Refined breakfast cereals
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| * White bread
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| * White rice
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| * Pasta
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| * Large starch portions
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| * Ultra-processed snacks
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| {{div col end}}
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| These foods can increase insulin levels and stimulate hepatic fat production. However, it is also important to note that total calorie excess, alcohol, and poor-quality dietary fat patterns may worsen fatty liver in some people. For best results, a low-carbohydrate or ketogenic approach should emphasize healthy fats, adequate protein, non-starchy vegetables, and medical monitoring.
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| ==Carbohydrates, fructose, and de novo lipogenesis==
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| The liver converts excess carbohydrate, especially sugar and fructose, into fat through a process called [[de novo lipogenesis]]. This process is accelerated by high insulin levels.
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| A diet high in refined carbohydrates may worsen:
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| {{div col|colwidth=15em}}
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| * Liver fat
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| * [[Triglycerides]]
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| * [[Insulin resistance]]
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| * [[Prediabetes]]
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| * [[Type 2 diabetes]]
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| * [[Abdominal obesity]]
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| * [[Metabolic syndrome]]
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| {{div col end}}
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| This is why reducing refined carbohydrates can be a powerful treatment strategy for many patients with fatty liver.
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| ==Symptoms==
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| Most people with fatty liver disease have no symptoms. The condition is often discovered on routine blood tests or imaging.
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| Possible symptoms include:
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| {{div col|colwidth=15em}}
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| * Fatigue
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| * Right upper abdominal discomfort
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| * Elevated liver enzymes
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| * Abdominal weight gain
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| * Brain fog
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| * Poor energy
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| * Symptoms of insulin resistance
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| {{div col end}}
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| Symptoms of advanced liver disease may include:
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| {{div col|colwidth=15em}}
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| * Jaundice
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| * Itching
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| * Fluid buildup in the abdomen
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| * Leg swelling
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| * Easy bruising
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| * Confusion
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| * Gastrointestinal bleeding
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| * Loss of appetite
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| * Muscle wasting
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| {{div col end}}
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| ==Risk factors==
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| Major risk factors include:
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| {{div col|colwidth=15em}}
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| * [[Insulin resistance]]
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| * [[Obesity]]
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| * [[Abdominal obesity]]
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| * [[Prediabetes]]
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| * [[Type 2 diabetes]]
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| * [[Metabolic syndrome]]
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| * [[PCOS]]
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| * [[Sleep apnea]]
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| * [[High triglycerides]]
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| * [[Hypertension]]
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| * [[Dyslipidemia]]
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| * Sedentary lifestyle
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| * Sugar-sweetened drinks
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| * Refined carbohydrate intake
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| * Family history
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| {{div col end}}
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| Other risk factors may include:
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| {{div col|colwidth=15em}}
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| * Rapid weight loss
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| * Certain medications
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| * Malnutrition
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| * Bowel disease
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| * Prior bariatric surgery complications
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| * Genetic risk factors
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| * Alcohol intake
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| {{div col end}}
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| ==Fatty liver and PCOS==
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| [[PCOS]] is strongly associated with insulin resistance. Women with PCOS often have higher risk of fatty liver, especially when there is abdominal weight gain, prediabetes, high triglycerides, or metabolic syndrome.
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| Treating insulin resistance may improve:
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| {{div col|colwidth=15em}}
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| * [[PCOS]]
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| * Fatty liver risk
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| * [[Prediabetes]]
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| * [[Acanthosis nigricans]]
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| * Sugar cravings
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| * Abdominal weight gain
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| * Menstrual irregularity in some patients
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| {{div col end}}
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| ==Fatty liver and prediabetes==
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| [[Prediabetes]] means blood glucose is above normal but not yet in the diabetes range. It is a warning sign of insulin resistance and often occurs with fatty liver. Fatty liver can worsen insulin resistance, and insulin resistance can worsen fatty liver, creating a cycle that increases risk for [[type 2 diabetes]].
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| ==Fatty liver and type 2 diabetes==
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| Patients with [[type 2 diabetes]] are at particularly high risk for MASLD, MASH, and advanced fibrosis. Current guidelines recommend case-finding for liver fibrosis in patients with cardiometabolic risk factors, especially type 2 diabetes or obesity with additional metabolic risk factors.{{cite journal|title=EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease|journal=Journal of Hepatology|year=2024|pmc=11299976}}
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| ==Fatty liver and metabolic syndrome==
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| [[Metabolic syndrome]] is a cluster of metabolic abnormalities that often includes:
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| {{div col|colwidth=15em}}
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| * Large waist circumference
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| * High triglycerides
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| * Low HDL cholesterol
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| * High blood pressure
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| * High fasting glucose
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| * Insulin resistance
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| {{div col end}}
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| Fatty liver is often considered the liver manifestation of metabolic syndrome.
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| ==Diagnosis==
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| Fatty liver may be suspected based on medical history, risk factors, blood tests, or imaging.
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| Evaluation may include:
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| {{div col|colwidth=15em}}
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| * [[Liver function test]]
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| * [[Alanine aminotransferase]]
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| * [[Aspartate aminotransferase]]
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| * [[Alkaline phosphatase]]
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| * [[Bilirubin]]
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| * [[Platelet count]]
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| * [[Hemoglobin A1c]]
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| * Fasting glucose
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| * Fasting insulin in selected cases
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| * [[Lipid profile]]
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| * [[Ultrasound]]
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| * [[FibroScan]]
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| * [[MRI]]
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| * [[CT scan]]
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| * Fibrosis scores
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| * Liver biopsy in selected cases
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| {{div col end}}
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| ==Fibrosis assessment==
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| The most important question in fatty liver disease is not just whether fat is present, but whether fibrosis or scarring is developing. Fibrosis increases the risk of cirrhosis and liver complications.
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| Common non-invasive tools include:
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| {{div col|colwidth=15em}}
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| * [[FIB-4 index]]
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| * [[NAFLD fibrosis score]]
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| * [[FibroScan]]
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| * Vibration-controlled transient elastography
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| * Enhanced liver fibrosis test
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| * MRI elastography
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| {{div col end}}
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| ==NAFLD, NASH, MASLD, and MASH==
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| Older terminology used [[NAFLD]] for fatty liver without significant alcohol use and [[NASH]] when inflammation and injury were present. Newer terminology uses MASLD and MASH.
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| {| class="wikitable"
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| ! Term
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| ! Meaning
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| |-
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| | Simple steatosis
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| | Fat buildup in the liver without major inflammation
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| |-
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| | MASH / NASH
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| | Liver fat plus inflammation and liver-cell injury
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| |-
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| | Fibrosis
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| | Scar tissue in the liver
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| |-
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| | Cirrhosis
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| | Advanced scarring and distortion of liver architecture
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| |}
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| ==Treatment overview==
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| The treatment of fatty liver focuses on reversing the metabolic drivers of liver fat.
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| Treatment goals include:
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| {{div col|colwidth=15em}}
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| * Reduce [[insulin resistance]]
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| * Reduce liver fat
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| * Lose excess body weight
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| * Reduce abdominal fat
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| * Improve triglycerides
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| * Prevent type 2 diabetes
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| * Treat PCOS-related insulin resistance
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| * Treat sleep apnea
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| * Prevent fibrosis
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| * Prevent cirrhosis
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| {{div col end}}
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| Lifestyle intervention remains the cornerstone of management. The AASLD guidance emphasizes diet leading to a calorie deficit and increased physical activity for patients with NAFLD who are overweight or obese.{{cite journal|last1=Rinella|first1=M. E.|title=AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease|journal=Hepatology|year=2023|volume=77|issue=5|pages=1797-1835|doi=10.1097/HEP.0000000000000323|pmid=36727674}}
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| ==Weight loss targets==
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| Weight loss is one of the best-proven treatments for fatty liver. Evidence suggests that:
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| {{div col|colwidth=20em}}
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| * About 5% weight loss may reduce liver fat
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| * About 7% weight loss may improve inflammation
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| * About 10% or more weight loss may improve or stabilize fibrosis in some patients
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| {{div col end}}
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| A 2025 review summarized that sustained weight loss of at least 5% reduces hepatic steatosis, at least 7% improves necroinflammation, and at least 10% may stabilize or reverse fibrosis.{{cite journal|title=Diet and Lifestyle Interventions in Metabolic Dysfunction-Associated Steatotic Liver Disease|journal=Journal of Clinical and Translational Hepatology|year=2025|pmc=12524441}}
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| ==Low-carbohydrate and ketogenic diet for fatty liver==
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| A [[low-carbohydrate diet]] or [[ketogenic diet]] can be especially effective for fatty liver when insulin resistance and carbohydrate overload are major drivers. The key benefit is not merely “eating fat,” but lowering insulin, lowering glucose load, reducing liver fat production, improving appetite control, and promoting fat loss.
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| A ketogenic diet is typically:
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| {{div col|colwidth=15em}}
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| * Very low in carbohydrates
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| * Moderate in protein
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| * Higher in fat
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| * Low in sugar
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| * Low in starch
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| * Focused on whole foods
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| * Designed to promote nutritional ketosis
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| {{div col end}}
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| Foods commonly emphasized include:
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| {{div col|colwidth=15em}}
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| * Eggs
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| * Fish
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| * Poultry
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| * Meat
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| * Greek yogurt in selected plans
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| * Cheese in controlled portions
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| * Tofu
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| * Non-starchy vegetables
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| * Leafy greens
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| * Avocado
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| * Olive oil
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| * Nuts in controlled portions
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| * Seeds
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| * Low-carb protein shakes
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| {{div col end}}
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| Foods commonly reduced or avoided include:
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| {{div col|colwidth=15em}}
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| * Sugar
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| * Sweetened drinks
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| * Fruit juice
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| * Candy
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| * Pastries
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| * White bread
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| * White rice
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| * Pasta
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| * Potatoes in large portions
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| * Sweetened cereals
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| * High-fructose foods
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| * Ultra-processed snacks
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| {{div col end}}
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| A 2025 review of ketogenic diets in steatotic liver disease reported that ketogenic diets significantly reduce hepatic fat content and improve metabolic parameters including insulin sensitivity and liver enzymes, while also noting that unsaturated fats and adequate protein may enhance benefits.{{cite journal|last1=Emanuele|first1=F.|title=Ketogenic Diet in Steatotic Liver Disease: A Metabolic Approach to Hepatic Fat Reduction|journal=Nutrients|year=2025|volume=17|issue=7|pages=1269|doi=10.3390/nu17071269}} Another review concluded that ketogenic diets and intermittent fasting should not be routinely recommended for every NAFLD patient but may be considered as alternative therapeutic options in patients who can tolerate and adhere to them, particularly when conventional approaches do not achieve target weight loss.{{cite journal|last1=Sripongpun|first1=P.|title=Current Evidence Concerning Effects of Ketogenic Diet and Intermittent Fasting in Patients with Nonalcoholic Fatty Liver|journal=Journal of Clinical and Translational Hepatology|year=2022|doi=10.14218/JCTH.2021.00494}}
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| ==Healthy fat versus unhealthy fat==
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| A ketogenic diet for fatty liver should not be interpreted as permission to eat unlimited processed meats, trans fats, fried foods, or excessive saturated fat. The best version is a medically supervised, nutrient-dense low-carbohydrate plan.
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| Preferred fats often include:
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| {{div col|colwidth=15em}}
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| * Olive oil
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| * Avocado
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| * Nuts
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| * Seeds
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| * Fatty fish
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| * Eggs
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| * Natural fats in whole foods
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| {{div col end}}
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| Fats to limit include:
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| {{div col|colwidth=15em}}
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| * Trans fats
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| * Deep-fried foods
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| * Highly processed meats
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| * Excessive saturated fat in high-risk patients
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| * Ultra-processed low-carb junk foods
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| {{div col end}}
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| ==Protein and muscle preservation==
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| Protein is important because weight loss without enough protein can reduce muscle mass. Preserving muscle helps improve insulin sensitivity and maintain metabolic rate.
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| Protein sources may include:
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| {{div col|colwidth=15em}}
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| * Fish
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| * Chicken
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| * Turkey
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| * Eggs
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| * Greek yogurt
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| * Cottage cheese
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| * Lean meat
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| * Tofu
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| * Tempeh
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| * Protein shakes
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| * Meal replacements
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| {{div col end}}
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| ==Exercise==
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| Exercise improves fatty liver even when weight loss is modest. Both aerobic exercise and resistance training can improve insulin sensitivity and reduce liver fat.
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| Helpful activities include:
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| {{div col|colwidth=15em}}
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| * Walking
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| * Post-meal walking
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| * Cycling
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| * Swimming
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| * Resistance training
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| * Weight training
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| * Resistance bands
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| * Chair exercise
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| * Daily step goals
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| {{div col end}}
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| ==Medications and new therapies==
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| Some medications used for obesity or diabetes may improve fatty liver risk factors. These may include:
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| {{div col|colwidth=15em}}
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| * [[GLP-1 receptor agonist]]s
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| * [[Semaglutide]]
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| * [[Tirzepatide]]
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| * [[Pioglitazone]] in selected patients
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| * [[Vitamin E]] in selected non-diabetic patients with biopsy-proven NASH
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| * [[Metformin]] for insulin resistance or diabetes, though not a specific NASH treatment
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| * [[Resmetirom]] for selected patients with MASH and fibrosis
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| {{div col end}}
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| AASLD notes that management of MASLD focuses on lifestyle modification and that resmetirom is currently FDA-approved for selected patients with F2-F3 fibrosis.{{cite web|url=https://www.aasld.org/liver-fellow-network/core-series/back-basics/steatotic-liver-disease-cutting-through-fat|title=Steatotic Liver Disease: Cutting Through the Fat|publisher=American Association for the Study of Liver Diseases|accessdate=June 25, 2026}}
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| ==GLP-1 weight loss and fatty liver==
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| [[GLP-1 receptor agonist]]s and related incretin medications may help fatty liver by producing weight loss, improving insulin resistance, reducing appetite, and improving metabolic risk factors.
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| Examples include:
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| {{div col|colwidth=15em}}
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| * [[Semaglutide]]
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| * [[Wegovy]]
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| * [[Ozempic]]
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| * [[Tirzepatide]]
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| * [[Zepbound]]
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| * [[Mounjaro]]
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| * [[Liraglutide]]
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| * [[Saxenda]]
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| {{div col end}}
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| These medications should be used under medical supervision, especially in patients with diabetes, gallbladder disease, pancreatitis history, severe gastrointestinal symptoms, pregnancy, or complex liver disease.
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| ==Alcohol and fatty liver==
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| Alcohol can worsen liver fat and liver inflammation. Patients with fatty liver should discuss alcohol use honestly with their clinician. In some patients, reducing or avoiding alcohol is essential.
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| ==How W8MD can help reverse fatty liver==
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| [[W8MD Weight Loss, Sleep and MedSpa]] Centers can help patients with fatty liver by treating the insulin resistance and weight-related drivers of the disease.
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| W8MD may help with:
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| {{div col|colwidth=15em}}
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| * Physician-supervised [[medical weight loss]]
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| * Evaluation of [[insulin resistance]]
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| * [[Prediabetes]] screening
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| * [[Type 2 diabetes]] risk reduction
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| * [[Metabolic syndrome]] treatment
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| * [[PCOS]]-related weight gain and insulin resistance
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| * [[Acanthosis nigricans]] recognition
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| * [[Low-carbohydrate diet]] planning
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| * [[Ketogenic diet]] guidance when appropriate
| |
| * [[Meal replacements]]
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| * [[Protein]] planning
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| * [[GLP-1 weight loss]] evaluation
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| * [[Semaglutide]] options when appropriate
| |
| * [[Tirzepatide]] options when appropriate
| |
| * [[Sleep apnea]] screening
| |
| * [[Home sleep test]]
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| * [[CPAP]] support
| |
| * Long-term [[weight maintenance]]
| |
| {{div col end}}
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| ==W8MD and insulin resistance-related conditions==
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| Because insulin resistance can drive multiple conditions at the same time, treating it may improve more than fatty liver.
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| | |
| W8MD may help reduce risk or improve:
| |
| | |
| {{div col|colwidth=15em}}
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| * [[Fatty liver disease]]
| |
| * [[PCOS]]
| |
| * [[Prediabetes]]
| |
| * [[Type 2 diabetes]]
| |
| * [[Metabolic syndrome]]
| |
| * [[High triglycerides]]
| |
| * [[Hypertension]]
| |
| * [[Acanthosis nigricans]]
| |
| * [[Sleep apnea]]
| |
| * [[Abdominal obesity]]
| |
| * [[Weight gain]]
| |
| {{div col end}}
| |
| | |
| ==Why W8MD’s approach is different==
| |
| W8MD focuses on the root metabolic process rather than simply telling patients to “eat less fat.” In many patients, fatty liver reflects insulin resistance caused or worsened by refined carbohydrates, sugar, obesity, poor sleep, and metabolic dysfunction.
| |
| | |
| W8MD’s approach may include:
| |
| | |
| {{div col|colwidth=15em}}
| |
| * Low-carbohydrate nutrition
| |
| * Ketogenic diet support when medically appropriate
| |
| * Meal replacements
| |
| * GLP-1 medication evaluation
| |
| * Sleep apnea testing
| |
| * Medical monitoring
| |
| * Lab review
| |
| * Long-term maintenance planning
| |
| {{div col end}}
| |
| | |
| ==Frequently asked questions==
| |
| ===What is fatty liver disease?===
| |
| Fatty liver disease is excess fat buildup inside liver cells. The most common metabolic form is now called [[metabolic dysfunction-associated steatotic liver disease]].
| |
| | |
| ===What is the true cause of fatty liver?===
| |
| In most patients with MASLD, the root cause is [[insulin resistance]]. Refined carbohydrates, sugar, fructose, obesity, abdominal fat, prediabetes, and type 2 diabetes can worsen insulin resistance and liver fat production.
| |
| | |
| ===Is fatty liver caused by eating fat?===
| |
| Usually not directly. Fatty liver is often driven more by insulin resistance and excess carbohydrate/sugar intake than by dietary fat alone. However, total calorie excess, alcohol, and poor-quality fats may worsen liver disease in some patients.
| |
| | |
| ===Can a ketogenic diet reverse fatty liver?===
| |
| A ketogenic or very low-carbohydrate diet may rapidly reduce liver fat in selected patients by lowering insulin and reducing carbohydrate-driven liver fat production. It should be medically supervised, especially in patients with diabetes, kidney disease, gallbladder disease, pregnancy, or advanced liver disease.
| |
| | |
| ===How much weight loss is needed to improve fatty liver?===
| |
| About 5% weight loss may reduce liver fat, 7% may improve inflammation, and 10% or more may help fibrosis in some patients.
| |
| | |
| ===Can fatty liver be reversed?===
| |
| Yes, early fatty liver can often improve or reverse with weight loss, carbohydrate reduction, improved insulin sensitivity, exercise, and treatment of metabolic risk factors. Advanced fibrosis or cirrhosis may not fully reverse and requires specialist care.
| |
| | |
| ===What foods should I avoid with fatty liver?===
| |
| Patients should reduce sugar, sweetened drinks, fruit juice, refined grains, white bread, white rice, pasta, pastries, candy, and ultra-processed snacks.
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| | |
| ===What conditions are linked to fatty liver?===
| |
| Fatty liver is linked to insulin resistance, prediabetes, type 2 diabetes, PCOS, metabolic syndrome, high triglycerides, hypertension, sleep apnea, and abdominal obesity.
| |
| | |
| ===Can W8MD help with fatty liver?===
| |
| Yes. W8MD can help patients reduce liver fat by treating insulin resistance through medical weight loss, low-carbohydrate or ketogenic diet planning, meal replacements, GLP-1 medications when appropriate, sleep apnea care, and long-term maintenance.
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| | |
| ==When to call a doctor==
| |
| Seek medical evaluation for:
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| | |
| {{div col|colwidth=15em}}
| |
| * Elevated liver enzymes
| |
| * Fatty liver on ultrasound
| |
| * Right upper abdominal pain
| |
| * Severe fatigue
| |
| * Jaundice
| |
| * Itching
| |
| * Abdominal swelling
| |
| * Leg swelling
| |
| * Confusion
| |
| * Vomiting blood
| |
| * Black stools
| |
| * Prediabetes
| |
| * Type 2 diabetes
| |
| * High triglycerides
| |
| * PCOS with weight gain
| |
| {{div col end}}
| |
| | |
| ==See also==
| |
| {{div col|colwidth=15em}}
| |
| * [[Fatty liver disease]]
| |
| * [[Metabolic dysfunction-associated steatotic liver disease]]
| |
| * [[Nonalcoholic fatty liver disease]]
| |
| * [[Nonalcoholic steatohepatitis]]
| |
| * [[Metabolic dysfunction-associated steatohepatitis]]
| |
| * [[Insulin resistance]]
| |
| * [[Metabolic syndrome]]
| |
| * [[Prediabetes]]
| |
| * [[Type 2 diabetes]]
| |
| * [[PCOS]]
| |
| * [[Acanthosis nigricans]]
| |
| * [[Low-carbohydrate diet]]
| |
| * [[Ketogenic diet]]
| |
| * [[Medical weight loss]]
| |
| * [[GLP-1 weight loss]]
| |
| * [[Semaglutide]]
| |
| * [[Tirzepatide]]
| |
| * [[Sleep apnea]]
| |
| * [[W8MD Weight Loss, Sleep and MedSpa]]
| |
| {{div col end}}
| |
| | |
| ==Further reading==
| |
| * {{cite journal|last1=Rinella|first1=M. E.|title=AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease|journal=Hepatology|year=2023|volume=77|issue=5|pages=1797-1835|doi=10.1097/HEP.0000000000000323|pmid=36727674}}
| |
| * {{cite journal|title=EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease|journal=Journal of Hepatology|year=2024|pmc=11299976}}
| |
| * {{cite journal|title=Diet and Lifestyle Interventions in Metabolic Dysfunction-Associated Steatotic Liver Disease|journal=Journal of Clinical and Translational Hepatology|year=2025|pmc=12524441}}
| |
| * {{cite journal|last1=Emanuele|first1=F.|title=Ketogenic Diet in Steatotic Liver Disease: A Metabolic Approach to Hepatic Fat Reduction|journal=Nutrients|year=2025|volume=17|issue=7|pages=1269|doi=10.3390/nu17071269}}
| |
| * {{cite journal|last1=Sripongpun|first1=P.|title=Current Evidence Concerning Effects of Ketogenic Diet and Intermittent Fasting in Patients with Nonalcoholic Fatty Liver|journal=Journal of Clinical and Translational Hepatology|year=2022|doi=10.14218/JCTH.2021.00494}}
| |
| * {{cite web|url=https://www.aasld.org/liver-fellow-network/core-series/back-basics/steatotic-liver-disease-cutting-through-fat|title=Steatotic Liver Disease: Cutting Through the Fat|publisher=American Association for the Study of Liver Diseases|accessdate=June 25, 2026}}
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| | |
| ==External links==
| |
| * [https://www.w8md.com W8MD Weight Loss, Sleep and MedSpa]
| |
| * [https://www.aasld.org/liver-fellow-network/core-series/back-basics/steatotic-liver-disease-cutting-through-fat AASLD - Steatotic Liver Disease]
| |
| * [https://pmc.ncbi.nlm.nih.gov/articles/PMC10735173/ AASLD Practice Guidance on NAFLD]
| |
| * [https://pmc.ncbi.nlm.nih.gov/articles/PMC11299976/ EASL-EASD-EASO MASLD Clinical Practice Guideline]
| |
| * [https://www.mayoclinic.org/diseases-conditions/fatty-liver-disease-masld/in-depth/self-care-for-fatty-liver-disease-masld/art-20587289 Mayo Clinic - Self-care for fatty liver disease]
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| {{Obesity}}
| |
| {{GLP-1}}
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| {{DEFAULTSORT:Fatty Liver Disease}}
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| [[Category:Fatty liver disease]]
| |
| [[Category:Metabolic dysfunction-associated steatotic liver disease]]
| |
| [[Category:Nonalcoholic fatty liver disease]]
| |
| [[Category:Nonalcoholic steatohepatitis]]
| |
| [[Category:Metabolic dysfunction-associated steatohepatitis]]
| |
| [[Category:Insulin resistance]]
| |
| [[Category:Metabolic syndrome]]
| |
| [[Category:Prediabetes]]
| |
| [[Category:Type 2 diabetes]]
| |
| [[Category:PCOS]]
| |
| [[Category:Acanthosis nigricans]]
| |
| [[Category:Ketogenic diet]]
| |
| [[Category:Low-carbohydrate diet]]
| |
| [[Category:Medical weight loss]]
| |
| [[Category:GLP-1 weight loss]]
| |
| [[Category:W8MD]]
| |
| [[Category:Sleep apnea]]
| |
| [[Category:Patient education]]
| |
