Fatty liver – What is it?

If you have recently undergone an ultrasound scan of your abdomen, you may find that the report states that you have a ‘fatty liver’. A lot of our patients tend to get concerned regarding this, so we thought it best to briefly discuss what a fatty liver actually is.

What is fatty liver?

As the name suggests, fatty liver refers to the deposition of fat on the surface of the liver. In the medical world, it is also called Non – Alcoholic Fatty Liver Disease (NAFLD). Fatty liver can also be caused due to alcohol – this has not been discussed here, but will be discussed in our future blog posts.

Fatty liver - Fat deposits are clearly seen on the liver.
Fatty liver – Fat deposits are clearly seen on the liver.

Normally, the liver that is healthy does not have any fat on its surface or within its cells. However, in patients who are overweight or obese, fat tissue can deposit within the liver, causing fatty liver. Fatty liver is a fairly common condition, and most patients do have some degree of fat deposition on the liver that will show up on an ultrasound scan.

What are the types of fatty liver?

Broadly classified, there are 4 stages of fatty liver depending on how much fat is deposited on the liver and how much damage has been done to the liver cells.

1. Stage 1 – Simple fatty liver

This is also called ‘steatosis’ and refers to the deposition of small amount of fat tissue on the liver. Most patients have no symptoms associated with this. It is often discovered after patients whose blood tests show an abnormal liver function have an ultrasound scan of their abdomen.

2. Stage 2 – Non – Alcoholic Steatohepatitis

Commonly called NASH, this condition is a bit more advanced than stage 1. The liver cells are inflamed and damage to the cells begin. Patients may experience pain in the abdomen where the liver is located.

3. Stage 3 –  Liver fibrosis

This refers to thickening and scar formation within the liver tissue that occurs due to long standing liver inflammation. This can affect the function of the liver.

4. Liver cirrhosis

This is an advanced stage of liver disease, where the healthy liver tissue is replaced by unhealthy scar tissue. The liver function is poor and the liver shrinks in size. It often occurs after years of damage to the liver tissue, and is unfortunately not reversible. Patients often have diabetes as well.

In patients who consume large amounts of alcohol everyday, fatty liver can occur. Pregnancy can also cause fatty liver, though this is quite rare.

Am I at risk?

There are a number of different risk factors that can lead to fatty liver. The table below lists the common ones.

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  • Overweight or obese
  • Alcohol
  • High blood pressure
  • High blood cholesterol / triglycerides
  • High fat diet
  • Rapid weight loss


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  • Age over 50 years
  • Type II diabetes mellitus
  • Malnourishment
  • Hepatitis C
  • Pregnancy




Is it serious?

Mild fatty changes on the liver scan with acceptable liver function tests is not serious. Just a few lifestyle changes can help reverse the damage to the liver.

On the other hand, fatty liver that progresses in the stages described above can be serious, and requires immediate attention. Patients can lose weight, become tired easily and can feel very weak. Patients can also become confused and may have trouble performing daily tasks. If the liver function is affected severely, then patients can become jaundiced and can bleed easily. Loss of muscle mass can also occur, and patients can accumulate fluid (pedal edema – read more). It can also cause liver cancer in its most advanced stages. NAFLD is also lined to the development of cardiovascular disease, and can increase the risk of heart disease by two fold.

In serious cases, patients may need additional tests to find out the cause of fatty liver. This can include obtaining a small sample of the liver tissue using a needle – a procedure called liver biopsy.

But do not worry, help is always at hand, and if you have concerns, make sure you discuss your report with your doctor.

What can I do to reverse fatty liver?

If fatty changes are mild, then there are certain things that you can do to prevent it from worsening, and helping reverse the damage.

1. Lose weight through diet and exercise

This probably the most important step. Weight loss can be achieved through diet and exercise. This weight loss needs to be gradual, as rapid weight loss can make fatty liver worse. Avoid high calorie foods such as rice, sweets, idlis, potatoes and sugar. Saturated fats such as ghee and palm oil can worsen the condition. If in doubt, seek help from a dietician on how to go about this.

2. Stop alcohol intake

Another important step. Stopping alcohol completely can reverse fatty liver damage in the early stages. This requires determination and perseverance, so make sure you make up your mind and tell yourself that you are going to do it!

3. Manage your diabetes

If you have type II diabetes and are taking treatment for it, make sure you observe the required treatment measures and dietary measures as prescribed by your doctor.

4. Take your medicines

If you are on treatment for high blood pressure or high cholesterol, make sure you take your treatment regularly and get your check ups are suggested by your doctor. There is believed to be a relationship between low vitamin D levels and non-alcoholic fatty liver disease, and vitamin D supplementation may be recommended.

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[note color=”#3aa3fd”]Fatty liver is reversible in its early stages. All it needs is a few lifestyle changes and medical treatment. This is easily done and is down to YOU! All it takes is a little determination![/note]



Fatty liver can occur due to a number of different causes. It is easily treated in the early stages, but can advance to an irreversible phase if left untreated.  Certain simple lifestyle measures can help treat this condition effectively in early stages.

Dr Vivek Baliga
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