Fatty liver disease, including steatotic liver and nonalcoholic fatty liver disease (NAFLD), is a condition where excess fat builds up in the liver, potentially leading to serious complications. While steatotic liver disease may be related to alcohol consumption, NAFLD occurs in people who drink little to no alcohol. Both conditions can be managed with lifestyle changes, proper diet, and sometimes medication.
What Is Steatotic (Fatty) Liver Disease?
Steatotic liver disease, commonly referred to as fatty liver disease, occurs when excess fat accumulates in the liver cells. It can be categorized into two main types: alcoholic and nonalcoholic. Alcoholic fatty liver disease (AFLD) is caused by excessive alcohol consumption, while nonalcoholic fatty liver disease (NAFLD) occurs in individuals who drink little to no alcohol.
Both conditions involve fat buildup without significant inflammation. When fatty liver disease progresses to include inflammation, it is known as nonalcoholic steatohepatitis (NASH), which can eventually lead to cirrhosis or liver failure. Fatty liver disease is often silent in its early stages, with symptoms being subtle or nonexistent, but if left untreated, it can cause serious liver damage over time.
Symptoms and Risk Factors of Fatty Liver Disease
Many people with fatty liver disease may not experience noticeable symptoms, especially in the early stages. However, as the condition progresses, symptoms such as fatigue, abdominal discomfort, and an enlarged liver may occur. For more advanced stages, such as NASH, individuals may experience jaundice, swelling in the legs or abdomen, and confusion due to liver dysfunction.
Risk factors for developing fatty liver disease include obesity, type 2 diabetes, high cholesterol, and high blood pressure. Other factors such as poor diet, a sedentary lifestyle, and certain medications can also increase the risk. Those who consume alcohol regularly are at a higher risk for alcoholic fatty liver disease. Early detection is essential to prevent further complications and to initiate treatment.
Treatment Options for Steatotic and Nonalcoholic Fatty Liver Disease
Treatment for steatotic and nonalcoholic fatty liver disease primarily focuses on lifestyle changes and managing underlying health conditions. For both alcoholic and nonalcoholic fatty liver disease, the first step is to reduce or eliminate alcohol consumption. For NAFLD, weight loss through diet and exercise is crucial for reversing the condition and improving liver health. Maintaining a healthy weight, controlling blood sugar, and reducing cholesterol can help prevent the progression to more serious liver diseases, such as cirrhosis.
While no specific medications are approved for NAFLD, doctors may recommend medications to manage related conditions like diabetes, high cholesterol, and high blood pressure. In some cases, lifestyle interventions alone can significantly improve liver function and prevent further liver damage.
Treatment for Nonalcoholic Steatohepatitis (NASH) and Medications
Nonalcoholic steatohepatitis (NASH) is an advanced form of nonalcoholic fatty liver disease (NAFLD) that involves both fat buildup and inflammation in the liver. Over time, NASH can lead to liver scarring and dysfunction. The primary treatment for NASH includes lifestyle changes such as weight loss, a balanced diet, and regular exercise to reduce liver fat and inflammation. In addition to these interventions, medications are now being explored.
The first FDA-approved medication for NASH, Rezdiffra (resmetirom), is a thyroid hormone receptor-beta (THR-beta) agonist used alongside diet and exercise. It is prescribed for adults with noncirrhotic NASH and moderate to advanced liver fibrosis (stages F2 to F3). As research continues, other potential medications are being tested to further improve treatment outcomes for NASH patients.
Managing Fatty Liver Disease for Long-Term Health
Fatty liver disease, including both steatotic liver and nonalcoholic fatty liver disease, can often be managed effectively with the right treatment and lifestyle adjustments. Early diagnosis, weight management, and control of underlying conditions like diabetes and high blood pressure play a crucial role in preventing further liver damage.
While medications for conditions like NASH are still being explored, adopting a healthy lifestyle remains the most effective strategy. By staying proactive and working with a healthcare provider, individuals can protect their liver health and reduce the risk of more severe complications in the future.
