Learning about fatty liver

Find answers to common questions.


Fatty liver (steatosis of the liver) is one of the most common reasons people have abnormal liver blood tests. The liver handles fat. It takes fats (lipoproteins) from the blood and releases them in a different form. The liver also makes and burns fat.

When the balance among these changes, fat can accumulate in the liver.

Below you can find answers to common questions you may have about fatty liver.

What causes fatty liver?

Most often fatty liver occurs in persons with obesity or type 2 (adult-onset) diabetes. Some medications can cause also fatty liver.

People with fatty liver have insulin resistance. The body’s sensitivity to insulin can go down with increasing body weight, age, or related to a family history of type 2 diabetes.

People with more fat around the abdomen (middle of the body) are more likely to have insulin resistance than people with fat elsewhere. With less sensitivity to insulin, the body must make more insulin to regulate blood sugar.

High blood insulin levels cause high blood pressure, increased triglycerides (a type of fat found in blood) and fatty liver. Drinking a lot of alcohol can also cause fatty liver.

How do I know if I have fatty liver?

Most people with fatty liver have no symptoms. If the liver is enlarged (if it has grown in size), there may be an ache or some tenderness in the right upper abdomen. 


Does too much fat hurt the liver?

At least 80% of people with fatty liver don't have any serious problems. If they lose weight and drink less alcohol, the fat goes away and the liver returns to normal.

Some 10–20% of people with fatty liver can have a more serious form of fatty liver. This problem is called steatohepatitis or NASH (non-alcoholic steatohepatitis).

If these problems happen, fat causes inflammation (swelling) and fibrosis (scar tissue) in the liver. Sometimes this form of fatty liver can lead to cirrhosis (serious liver disease) and liver failure.  


How do I know what's wrong with my liver?

We often become aware of a liver problem because of an abnormal ultrasound or because of abnormal results from a blood test. 

Will I need a liver biopsy?

A liver biopsy (when a sample of tissue is taken from the body and tested) is usually done in persons with abnormal liver tests for more than six months.

Persons with more serious fatty liver are usually older, are overweight or have type 2 diabetes. The best to handle fatty liver is weight loss and exercise to improve insulin resistance.


What can I do about fatty liver? 

If you have fatty liver, you should drink much less alcohol. If you're overweight, you should also lose weight. Exercise (physical movement) along with weight loss is the best way to handle fatty liver.

What will happen if I have fatty liver?

If your liver biopsy shows many negative changes, you're more likely to have serious liver problems in the future. Few people with fatty liver have cirrhosis except people who are very overweight. Most of the time liver damage in fatty liver happens slowly. 

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The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.