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Fatty liver is a condition in which there is an accumulation of excess fat within the liver cells.


Types of fatty liver

This can occur in two forms: alcoholic fatty liver disease, which is caused by excessive alcohol consumption, and nonalcoholic fatty liver disease (NAFLD), which is caused by a variety of factors, including obesity, insulin resistance, and high levels of triglycerides in the blood.

NAFLD liver progression

Non-alcoholic fatty liver disease

NAFLD is a common condition in which excess fat accumulates in the liver, leading to liver inflammation and damage. It can develop in people who drink little or no alcohol, and is often associated with obesity, insulin resistance, and metabolic syndrome. Symptoms of NAFLD can include fatigue, abdominal pain, and elevated liver enzymes. NAFLD can progress to a more severe form called nonalcoholic steatohepatitis (NASH), which can lead to cirrhosis, liver failure, and other serious health problems. Treatment for NAFLD often focuses on lifestyle changes such as losing weight, eating a healthy diet, and increasing physical activity. In severe cases, medications and other treatments may be necessary to control liver inflammation and prevent liver damage.

Non-alcoholic fatty liver disease

Risk factors

MRI Liversteatosis


  • How do you diagnosis of NASH or fatty liver? NASH is diagnosed with a combination of medical history, a physical exam, and tests to diagnose nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).
  • What is the difference between NAFLD and NASH? NAFLD is when you have no symptoms but have findings of fat accumulation in your liver. NASH is when you start having symptoms. Other tests may include blood tests, imaging tests, and sometimes liver biopsy.
  • How common is NAFLD and NASH? NAFLD is one of the most common causes of liver disease in the United States. Most people with NAFLD have simple fatty liver. Only a small number of people with NAFLD have NASH. Experts estimate that about 20 percent of people with NAFLD have NASH. Between 30 and 40 percent of adults in the United States have NAFLD. About 3 to 12 percent of adults in the United States have NASH.
  • How do you treat NASH or fatty liver disease? Changing underlying process leading to NASH or fatty liver called insulin resistance is key to the treatment of NASH.
  • Can you have NASH or fatty liver and have no symptoms from it? Yes. People with NAFLD often have no symptoms.


  • When symptoms do occur, what are the most common symptoms?
  • Fatigue
  • Pain in the upper right abdomen
  • In people with NASH who have liver damage (cirrhosis), what symptoms are seen? Weakness
  • Loss of appetite
  • Nausea
  • Yellow skin and eyes (jaundice)
  • Itching
  • Fluid buildup and swelling in the legs and abdomen
  • Mental confusion
  • GI bleeding

Exams and Tests

  • Since NAFLD does not have symptoms, it is often found during routine blood tests that are used to see how well the liver is working.
  • You may have the following tests to measure liver function:
  • Complete blood count
  • Prothrombin time
  • Blood albumin level
  • Ultrasound is often used to confirm a diagnosis of NAFLD
  • MRI and CT scan may also be needed
  • A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD.


  • What is the prognosis for NASH, NAFLD or fatty liver disease? Many people with NAFLD have no health problems and do not go on to develop NASH. Losing weight and making healthy lifestyle choices can help prevent more serious problems. It is unclear why some people develop NASH. NASH can lead to cirrhosis.


  • How do you prevent NASH? To help prevent NAFLD:
  • Maintain a healthy weight
  • Eat a healthy diet
  • Exercise regularly
  • Limit alcohol consumption

Also see

Stage of liver damage

Frequently asked questions

  • What is fatty liver or NASH / NAFLD? Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in your liver. Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. If you have NASH, you have inflammation and liver cell damage, along with fat in your liver.
  • What are the signs and symptoms of NASH? Usually, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) cause few or no symptoms. Certain health conditions—including obesity, metabolic syndrome, and type 2 diabetes—make you more likely to develop NAFLD and NASH.
  • What causes fatty liver or NASH? The true underlying process that eventually leads to fatty liver is called insulin resistance.
  • How do I know if I am insulin resistance that can lead to fatty liver? You can use the W8MD's insulin resistance calculator tool to help determine if you may be at risk for insulin resistance and by extension, fatty liver or NASH.
  • What other conditions are related to NASH? Since insulin resistance, the root cause of NASH or fatty liver, also causes many other things including weight gain, the following conditions are associated with NASH.

How can W8MD help?

  • W8MD's weight loss program with it's emphasis on treating insulin resistance as opposed to just weight loss is the ideal way to treat nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). W8MD's weight loss program can reduce fat in the liver, inflammation, and fibrosis.


  1. Valenti, L., Bellentani, S., & Sasso, F. (2017). The epidemiology of nonalcoholic fatty liver disease: An update. Metabolic Brain Disease, 32(3), 557-567. doi: 10.1007/s11011-016-9898-3
  2. Browning, J. D., & Horton, J. D. (2004). Molecular mechanisms of fatty liver disease. Journal of Clinical Investigation, 113(11), 1408-1416. doi: 10.1172/JCI21625
  3. Zhang, X., & Reichard, G. A. (2015). Fatty liver disease: An update on diagnosis, management, and treatment. American Journal of Gastroenterology, 110(12), 1622-1632. doi: 10.1038/ajg.2015.287

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