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School of Medicine
Fatty liver, or hepatic steatosis, refers to excessive fat accumulation in the liver. In the absence of high alcohol consumption, it is termed non-alcoholic fatty liver disease (NAFLD). Obesity, and medical conditions such as hypertension, hypercholesterolemia, and diabetes, are risk factors for the development of NAFLD. In some patients, fat causes liver inflammation, or steatohepatitis; also referred to as non-alcoholic steatohepatitis (NASH). NASH may eventually cause liver scarring (fibrosis), leading to cirrhosis.
How do I know if I have fatty liver disease?
Fatty liver disease does not cause symptoms. However, your doctor may find elevated liver enzymes after a routine blood test. The liver releases the enzymes ALT and AST when there is inflammation.
Obesity and fatty liver disease
Non-alcoholic fatty liver disease is strongly associated with obesity. Excess fat causes insulin resistance and inflammatory signals. Insulin resistance means that the pancreas has to produce more insulin in order to maintain normal blood glucose levels, and is the first step towards developing diabetes.
Patients who have hypertension (high blood pressure), have high cholesterol, are overweight or obese, and have diabetes or insulin resistance are at greater risk to develop fatty liver disease. Physicians and scientists do not fully understand why the excess fat causes these liver changes. They do know that by losing weight, liver enzymes may normalize and liver inflammation may improve.
How much weight do I have to lose so I can cure my fatty liver disease?
Studies show that losing 10 percent of your weight causes the liver enzymes to improve, which correlates with a reduction in the liver inflammation caused by the extra fat.
Can fatty liver disease make it harder for me to lose weight?
Fatty liver disease should not make it harder for you to lose weight. However, you will have to follow a strict eating and exercise plan in order to lose weight. The doctors at Johns Hopkins may need to treat your fatty liver disease with a combination of medications in order to achieve adequate glucose control and normal cholesterol levels.