Fatty liver disease is also known as NASH or MAFLD. The full form for Nash is Non-alcoholic steatohepatitis, and that for MAFLD is metabolically Associated Fatty Liver Disease.

Fatty Liver: A Guide to Prevention and Treatment

March 23, 2024 by Dr. Sandeep Bhasin

Fatty liver disease is a condition that affects millions of people worldwide. It is characterized by the accumulation of fat in the liver cells, which can lead to inflammation, liver damage, and other complications if left untreated. In this article, we will provide a comprehensive guide to the prevention and treatment of fatty liver, covering its causes, symptoms, diagnosis, prevention strategies, fatty liver treatment options, and potential complications.

Fatty liver disease is also known as NASH or MAFLD. The full form for Nash is Non-alcoholic steatohepatitis, and that for MAFLD is metabolically Associated Fatty Liver Disease. It involves the accumulation of 5% or more fat in the liver. Fatty liver disease is not solely a liver condition but a result of insulin resistance. It indicates a pre-diabetic state where the insulin hormone functions incorrectly. Once the fat accumulates in the liver, taking measures to control it becomes crucial. Leaving fatty liver untreated can lead to liver failure or liver cirrhosis over the course of fifteen to twenty years. Individuals with fatty liver disorders are more likely to develop diabetes than those without such a condition.

Causes of Fatty Liver

Fatty liver disease can be caused by various factors, including:

  • Obesity and overweight: Excess weight, particularly around the abdomen, increases the risk of developing fatty liver.
  • Poor diet: A diet high in refined carbohydrates, sugar, and saturated fats can contribute to fatty liver.
  • Insulin resistance: Insulin resistance, often associated with obesity and type 2 diabetes, can lead to fat accumulation in the liver.
  • Alcohol consumption: Excessive alcohol intake can cause alcoholic fatty liver disease.
  • Medications: Certain medications, such as corticosteroids and tamoxifen, can contribute to the development of fatty liver.

Types of Fatty Liver Disease

stages of fatty liver
stages of fatty liver

There are two main types of fatty liver disease:

Non-alcoholic Fatty Liver Disease (NAFLD)

NAFLD is the most common form of fatty liver disease and is not related to alcohol consumption. It is strongly associated with obesity, insulin resistance, and metabolic syndrome. NAFLD can progress from simple fatty liver to a more severe form called non-alcoholic steatohepatitis (NASH) if inflammation and liver cell damage occur.

Alcoholic Fatty Liver Disease (AFLD)

AFLD is caused by excessive alcohol consumption. When alcohol is metabolized in the liver, it produces toxic byproducts that can damage liver cells and lead to fat accumulation. Continued alcohol abuse can progress AFLD to more severe liver conditions, such as alcoholic hepatitis or cirrhosis.

Symptoms and Diagnosis

Common Symptoms of Fatty Liver

In the early stages, fatty liver often does not cause noticeable symptoms. However, as the condition progresses, symptoms may include:

  • Fatigue
  • Abdominal discomfort or pain
  • Loss of appetite
  • Weight loss
  • Jaundice (yellowing of the skin and eyes)

Diagnostic Tests for Fatty Liver

To diagnose fatty liver disease, various tests may be performed, including:

  • Blood tests: Elevated liver enzymes and abnormal lipid profiles may indicate fatty liver.
  • Imaging tests: Ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can visualize the liver and detect fat accumulation.
  • Liver biopsy: A small sample of liver tissue is examined under a microscope to determine the severity of liver damage and rule out other liver diseases.

Fatty Liver And its Relationship with other diseases

Having a fatty liver condition increases the risk of acquiring other diseases, including cancer. Heart conditions, strokes, cardiac casualties, and coronary artery disorders are more common in individuals with fatty liver disease. Maintaining a healthy lipid profile is essential, with specific targets for triglyceride levels and HDL cholesterol. Elevated liver enzymes indicate liver inflammation and the potential progression to liver fibrosis. Lifestyle management and weight loss are crucial for managing fatty liver disease.

Diseases Associated with Fatty Liver

  • Individuals with fatty liver disease are about four times more likely to develop cancer.
  • Heart conditions, strokes, impulsive cardiac casualties, and coronary artery disorders are higher in individuals with fatty liver disease.
  • Chances of developing hepatocellular carcinoma (liver cancer) increase.

Importance of Lipid Profile

  • Maintaining a healthy lipid profile is crucial.
  • Triglyceride levels should be below 150.
  • HDL cholesterol should be above 50 in females and 40 in males.
  • Obesity indicators, such as waist circumference exceeding 90cm in males and a body mass index (BMI) over 25, indicate increased risks.

Liver Enzymes and Liver Fibrosis

  • Elevated SGOT and SGPT liver enzymes are evidence of liver inflammation caused by uncontrolled nonalcoholic steatohepatitis (NASH).
  • If NASH is not timely treated, it can progress to liver fibrosis.
  • Diagnosis involves monitoring body weight, lipid profile, blood sugar levels, and HOMA-IR in the blood.
  • Liver ultrasound reveals the size of fat accumulation.
  • Elastography or fibroscan indicates the degree of liver fibrosis.

There is no highly effective medication to reverse fatty liver disease, emphasizing the importance of lifestyle management and weight loss in its management.

How To Manage Fatty Liver Diseases?

When it comes to managing fatty liver disease, there are several key strategies to consider:

  1. Weight loss: Losing weight can significantly improve fatty liver disease. Regimes like intermittent fasting may be helpful in achieving weight loss goals.
  2. Reduce carbohydrate intake: Decreasing the consumption of carbohydrates, especially refined sugars, can aid in controlling fatty liver disease.
  3. Limit fructose intake: Fructose can be detrimental to fatty liver disease, similar to alcohol. Therefore, avoiding fruit juices and sweets high in fructose is advisable.
  4. Restrict trans fatty acids and oily foods: Trans fatty acids found in processed and fried foods should be minimized to protect liver health.
  5. Avoid alcohol: Alcohol consumption should be completely avoided as it can further damage or worsen fatty liver conditions.
  6. Be cautious with medications: Certain medications, such as methotrexate and acitretin, can harm the liver. It is important to avoid any medication that can exacerbate liver damage.
  7. Focus on a healthy diet: Eat a balanced and nutritious diet rich in fruits, vegetables, lean proteins, and whole grains. This supports overall liver health and aids in managing fatty liver disease.
  8. Seek professional guidance: Consider enrolling in weight loss programs or consulting with healthcare professionals specializing in liver health to receive personalized guidance and support.
how to manage fatty liver diseases
how to manage fatty liver diseases

By following these recommendations, individuals can take significant steps toward managing and improving fatty liver disease. However, consulting with a healthcare professional for proper diagnosis, treatment, and personalized advice based on individual circumstances is crucial.

Other Treatments For Fatty Liver Disease

When it comes to treating fatty liver disease, different treatment procedures are available. Non-surgical approaches include ozone lipolysis, which involves using ozone therapy to target and dissolve fat deposits. Cryolipolysis, another non-invasive procedure, utilizes controlled cooling to reduce fat in specific areas. Special injections can also be administered to dissolve fat.

Treatment options for fatty liver
Treatment options for fatty liver
  • Gastric ballooning can be an option for individuals with high body weight who cannot exercise. This procedure involves placing a balloon in the stomach to create a feeling of fullness, aiding in weight loss.
  • In addition to these treatments, certain supplements can be used as injectable drips to effectively reverse fatty liver disease. These supplements may contain nutrients and antioxidants that support liver health and promote fat metabolism.
  • It is of the utmost importance that you connect with a knowledgeable and certified professional to discuss the treatment options. They can evaluate individual cases, provide accurate diagnoses, and recommend the most suitable treatment approach based on the severity of the fatty liver disease and the patient’s overall health condition.

Treatment Option 1:

Phosphatidylcholine injection and other substances like L-carnitine, glutathione, Myer’s protocol, and vitamin C can offer potential benefits for reducing fatty liver in conjunction with lifestyle management. Phosphatidylcholine is a kind of phospholipid that contributes to the functioning and structuring of cell membranes. It also helps in the structuring and functioning of the liver membranes. Naturally, it is found in food items like soybeans, eggs, and sunflower seeds. Phosphatidylcholine injection injects a concentration of the phospholipid dose straight into the human body. When combined with L-carnitine, glutathione, Myer’s protocol, and vitamin C, the phosphatidylcholine injection may enhance fatty liver reduction. Here’s a short overview of the additional elements:

  1. L-carnitine: L-carnitine is a form of amino acid that plays an essential role in the metabolism of energy. It helps transport fatty acids into the mitochondria, converting them into energy. By enhancing the oxidation of fatty acids, L-carnitine might help diminish fat accumulation in the body.
  2. Glutathione: Glutathione is a powerful antioxidant produced naturally in the body. It helps protect cells from oxidative damage and supports liver detoxification processes. Glutathione helps promote liver health by helping to detoxify and reduce oxidative stress. 
  3. Myer’s protocol: Myer’s protocol is a combination of vitamins and minerals administered intravenously. It typically includes B vitamins, magnesium, calcium, and vitamin C. Although limited scientific evidence specifically links Myer’s protocol to fatty liver reduction, including B vitamins and vitamin C may benefit liver health and overall well-being.
  4. Vitamin C: Vitamin C is a potent antioxidant supporting immune function, collagen synthesis, and detoxification. While it is not completely understood how vitamin C helps reverse a fatty liver, its antioxidant benefits might help in liver protection. 
  5. Vitamin E: Vitamin E has been shown to be beneficial in the treatment of non-alcoholic fatty liver disease (NAFLD). By acting as an antioxidant, it defends liver cells from oxidative stress-related harm. Studies have indicated that supplementation with vitamin E can help reduce liver inflammation, improve liver enzyme levels, and decrease fat accumulation in the liver. However, it is important to note that the use of vitamin E should be under medical supervision, and the dosage should not exceed the recommended daily intake to avoid potential side effects.

The recommended dosage of the combination injection is typically 10–20 drips. However, you must consult a qualified and experienced professional to determine the treatment process and dosage based on your medical history and customized requirements. 

It’s worth mentioning that while the combination injection may offer potential benefits, it should not be considered a standalone treatment for fatty liver. Lifestyle management, including dietary modifications, exercise, and addressing underlying causes such as alcohol consumption or obesity, remains crucial for the long-term management of fatty liver. You should consult a healthcare specialist, like a gastroenterologist or hepatologist, to effectively evaluate your condition, discuss the possible treatment options, and craft a comprehensive plan to manage your fatty liver condition. 

Treatment option 2:

Saroglitazar has been developed to treat fatty liver disease and related conditions. It is selective with its targets and effectively modulates the PPAR receptors, specifically the PPAR-gamma and PPAR-alpha receptors. PPAR-gamma helps with glucose metabolism and insulin sensitivity. PPAR-alpha, on the other hand, helps in lipid metabolism, including triglyceride clearance and breakdown. By inhibiting PPAR-alpha, saroglitazar helps decrease triglyceride levels in the blood. People with fatty liver illnesses are often seen with elevated triglyceride levels and are more likely to develop cardiovascular problems. Saroglitazar’s action on PPAR-alpha can help manage dyslipidemia (abnormal lipid levels) by reducing triglycerides and improving the overall lipid profile.

Additionally, saroglitazar’s activation of PPAR-gamma can improve insulin sensitivity and glucose metabolism. Insulin resistance is commonly related to type 2 diabetes and fatty liver diseases. It is a condition where the body’s cells are less responsive to the effects of insulin. By reducing insulin resistance, saroglitazar may help improve glycemic control in individuals with type 2 diabetes and fatty liver disease, potentially leading to better management of blood sugar levels.

Furthermore, saroglitazar has shown promise in the treatment of NASH, a more severe form of fatty liver disease characterized by liver inflammation and damage. Activating PPAR-gamma by saroglitazar can help reduce inflammation in the liver and improve insulin sensitivity, which are important factors in managing NASH.

Saroglitazar should be used under the prescription of a healthcare professional. The treatment process and dosage may differ based on the patient’s condition. Monitoring liver function, lipid levels, and blood sugar control is typically recommended during treatment. While saroglitazar shows promise in managing fatty liver disease and related conditions, it should be part of a comprehensive treatment plan that includes lifestyle modifications. Lifestyle changes are essential for the long-term management of fatty liver disease.

Treatment option 3:

Pioglitazone has proven effective in managing NASH, an advanced stage of fatty liver disease. It typically activates and targets PPAR-gamma in the fatty tissues, skeletal muscles, and liver. PPAR-gamma activation improves insulin sensitivity, decreases insulin resistance, and enhances glucose utilization. Pioglitazone has been proven to reduce liver fibrosis. Liver fibrosis is the formation of massive scar tissues in the liver. 

Pioglitazone’s mechanism of action includes suppressing inflammatory responses and inhibiting the activation of hepatic stellate cells, which are key players in developing liver fibrosis. By limiting and inhibiting the fibrotic process, pioglitazone helps to reverse or slow down liver fibrosis in patients suffering from NASH. It is important to note that a healthcare professional should prescribe and monitor pioglitazone.

The treatment process and the required dosage may vary based on factors like NASH severity, medicine response, and comorbidities. Like any other medication, pioglitazone has potential side effects like edema, weight gain, and an enhanced risk of heart failure. It is crucial to discuss potential risks, benefits, and any existing medical conditions with a healthcare professional before starting pioglitazone treatment. Pioglitazone is often part of a comprehensive treatment approach for NASH, which should include lifestyle modifications.

Treatment option 4:

Pioglitazone is an available medication for treating type 2 diabetes. It has shown effectiveness in the management of NASH. It also enhances insulin sensitivity in the fatty tissues, which helps control blood sugar levels. Pioglitazone also reduces liver fibrosis by inhibiting the activation of cells responsible for scar tissue formation. It should be used under medical supervision, considering potential side effects like weight gain and fluid retention. Lifestyle changes and regular monitoring are essential to NASH management.

Treatment option 5:

SGLT2 inhibitors are anti-diabetic drugs that effectively manage fatty liver disease. They aid the patient by promoting weight loss, lowering blood glucose levels, decreasing liver inflammation, and enhancing insulin sensitivity. However, the patient must be monitored under medical supervision. It must be part of the comprehensive treatment plan, including lifestyle alterations.

Treatment option 6:

GLP1 agonists, such as Semaglutide and Liraglutide, are medications for treating type 2 diabetes and aiding weight loss. These medications help manage fatty liver disease by helping with weight loss, enhancing fibrosis and steatosis, and reducing liver inflammation and enzymes. However, they should be used under medical supervision and with lifestyle modifications for optimal results in fatty liver management.

Directly targeting drugs for fatty liver disease requires further research and study. However, medications designed to aid in weight management, control obesity, regulate metabolism, and specifically treat type 2 diabetes can also impact fatty liver conditions. These drugs may benefit from managing and improving fatty liver disease, although more research is needed to fully understand their effectiveness.

Some common myths about fatty livers

  1. Udaliv for fatty liver: Udaliv, also known as ursodeoxycholic acid (UDCA), has been traditionally used as a hepatoprotective medication for liver conditions, including fatty liver. However, as per recent studies, the effectiveness of udaliv may not be as effective as previously stated. Udaliv may have limited benefits and is generally considered more suitable for individuals with normal livers who require liver protection.
  2. Fatty liver is not a serious condition: Fatty liver disease may start as a little fat accumulation in the liver but is associated with higher health risks. The risks can lead to more severe conditions like cancer, NASH, or liver fibrosis.
  3. Only alcoholics are prone to fatty liver conditions: A fatty liver ailment is not solely limited to individuals with alcohol consumption issues. While fatty liver in alcoholics is a specific form of fatty liver condition, NAFLD is more common and can affect individuals without excessive alcohol consumption. NAFLD risk factors include body fat, type 2 diabetes, insulin resistance, high cholesterol, metabolic syndrome, and genetic factors. The exact cause of NAFLD is not fully understood. However, it may involve genetic, environmental, and lifestyle aspects.
  4. Fatty liver disease is non-reversible: Unlike the belief that fatty liver disease is irreversible, lifestyle modifications and proper management can reduce liver fat content and potentially reverse the condition. 

Following healthy eating habits, regularly exercising, attaining healthy body weight, maintaining it, and avoiding alcohol consumption are the major aspects of managing fatty liver disease. When followed regularly, such factors help decrease fat accumulation and improve overall liver health. However, it is essential to remember that the rate of reversibility may vary based on the different stages and circumstances of the disease. 

Some common myths about fatty livers
Some common myths about fatty livers

It is important to consult with a learned and experienced professional for customized treatment, an accurate diagnosis, and correct guidance on how to move ahead with managing the disease. They can carefully monitor different cases, evaluate individual factors like medical history, underlying conditions, etc., and provide the perfect treatment options.

Complications and Risks


If fatty liver progresses to non-alcoholic steatohepatitis (NASH), it can cause inflammation and damage to liver cells. NASH can lead to fibrosis, and scarring of the liver, and may progress to cirrhosis or liver cancer if left untreated.


Cirrhosis is the advanced stage of liver disease characterized by extensive scarring and irreversible damage to the liver tissue. It can result from various causes, including prolonged alcohol abuse and advanced NASH.


Fatty liver disease is a complex condition that requires timely attention and management to prevent complications. Monitoring and maintaining a healthy lipid profile while adopting a proper diet and lifestyle is important. Individuals with fatty livers should avoid consuming oily, fried, and sugary foods to avoid further fat deposition around the liver and associated complications. By taking these precautions, individuals can minimize the risks and promote the health of their liver.


  • What are the causes of fatty liver?
  • How can fatty liver be prevented?
  • What are the treatment options for fatty liver?
  • Can fatty liver be reversed?
  • Is fatty liver a serious condition?
  • Are there any complications associated with fatty liver?
  • Can medications help treat fatty liver?
  • Is a specific diet recommended for fatty liver?
  • How long does it take to reverse fatty liver disease?
  • Can fatty liver occur in non-alcoholics?
  • Is regular exercise beneficial for fatty liver?
  • Is fatty liver a common condition?
What are the causes of fatty liver?

Causes of fatty liver include obesity, high alcohol consumption, diabetes, high cholesterol, and certain medications.

How can fatty liver be prevented?

Prevent fatty liver by maintaining a healthy weight, consuming a balanced diet, limiting alcohol intake, and exercising regularly.

What are the treatment options for fatty liver?

Treatment for fatty liver involves lifestyle changes such as weight loss, healthy eating, exercise, and avoiding alcohol. In some cases, medications may be prescribed.

Can fatty liver be reversed?

Yes, fatty liver can be reversed through lifestyle changes and treating the underlying causes.

Is fatty liver a serious condition?

Fatty liver can progress to more severe conditions like liver cirrhosis or liver failure if left untreated, so it should be taken seriously.

Are there any complications associated with fatty liver?

If left untreated, fatty liver disease can progress to more severe liver diseases, such as liver fibrosis and cirrhosis. It also increases the risk of developing liver cancer.

Can medications help treat fatty liver?

Medications may be prescribed to manage underlying conditions contributing to fatty liver, but there is no specific medication for treating fatty liver itself.

Is a specific diet recommended for fatty liver?

A healthy, balanced diet low in saturated fats and high in fruits, vegetables, whole grains, and lean proteins is recommended for a fatty liver.

How long does it take to reverse fatty liver disease?

The time it takes to reverse fatty liver varies depending on the individual, their adherence to lifestyle changes, and the severity of the condition. It may take weeks, months, or longer.

Can fatty liver occur in non-alcoholics?

Yes, fatty liver can occur in non-alcoholics. Non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, diabetes, and the metabolic syndrome.

Is regular exercise beneficial for fatty liver?

Yes, regular exercise has been shown to be beneficial for fatty liver. Engaging in moderate-intensity aerobic activities, such as brisk walking or cycling, for at least 150 minutes per week can help reduce liver fat and improve overall liver health.

Is fatty liver a common condition?

Yes, fatty liver disease is a common condition worldwide. It is often associated with obesity, type 2 diabetes, high cholesterol, and the metabolic syndrome. However, it can also occur in individuals who are not overweight.


  1. Younossi ZM. Koenig AB. Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease – Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73–84. [PubMed[]
  2. Ghevariya V. Sandar N. Patel K, et al. Knowing what’s out there: awareness of non-alcoholic fatty liver disease. Front Med. 2014;1:4. [PMC free article] [PubMed[]
  3. Bambha K. Belt P. Abraham M, et al. Ethnicity and nonalcoholic fatty liver disease. Hepatology. 2012;55:769–80. [PMC free article] [PubMed[]
  4. Romeo S. Kozlitina J. Xing C, et al. Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease. Nat Genet. 2008;40:1461–5. [PMC free article] [PubMed[]
  5. Ekstedt M. Hagström H. Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61:1547–54. [PubMed[]
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Dr. Sandeep Bhasin

Dr. Sandeep Bhasin is a highly skilled cosmetic surgeon and the owner of Care Well Medical Centre in Delhi. With extensive expertise in cosmetic and plastic surgery, he is dedicated to providing exceptional care and transformative results to his patients. Dr. Sandeep Bhasin obtained his MBBS and MS in General Surgery from Aligarh Muslim University (AMU) and served as a consultant at Bhaktshreshtha Kamalakarpant Laxman Walawalkar Hospital, Diagnostic & Research Centre. Specializing in various procedures such as face-lifts, rhinoplasty, liposuction, breast augmentation, hair transplant and many others, Dr. Sandeep Bhasin is committed to enhancing his patients' natural beauty and self-confidence.

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