Nonalcoholic Fatty Liver Disease (NAFL) | What Do I Need to Know?


There is no specific treatment for fatty liver disease. However, many changes to lifestyle can easily reverse fatty liver and prevent the progression to hepatitis or liver failure. Medications can also be used to reduce the amount of fats in your blood and to improve liver function. End-stage liver disease has no cure except liver transplantation. However, for this to occur, it takes many years.

The main changes that need to be done are related to diet and exercise. Fatty liver develops when the body does not consume the carbohydrates and fats it ingests, resulting in their accumulation within liver cells. A healthy diet containing all the essential food constituents is key to achieving this. Many diets exist that claim to protect against or treat fatty liver. However, the most scientifically proven diet to achieve this is the Mediterranean diet.

The Mediterranean diet mainly relies on vegetable oils, fish for protein and vegetables and fruits for vitamins. It contains less harmful fats and red meat. It also contains nuts which provide the body with omega-3 fatty acids. The Mediterranean diet is also rich in antioxidants which reduces inflammation usually present in fatty liver disease.

Exercise is also essential to management. All humans should exercise a minimum of 30 minutes per day. Not only does it help get rid of fat. It also promotes general health, mental wellbeing and protects against countless diseases from heart attacks to cancer. You can start by brisk walking then go up to more aerobic exercise as running, swimming and cycling.

Pharmacological treatment

Pharmacological treatment is not always needed, and it is only resorted to late in the disease and when lifestyle changes fail to achieve the desired effects. The main medications used in fatty liver disease are:

  • Vitamin E: It is the only pharmacological therapy to show benefit in patients with fatty liver disease, but its evidence is yet to gain approval by the FDA. Vitamin E can also be found in plant oils, whole grains and nuts all present in the Mediterranean diet.
  • Omega-3 Fatty acids: Omega-3 fatty acids have been prescribed for decades for patients with elevated lipid profile, yet its use in fatty liver disease is still questionable. It can be found naturally in nuts and fish.
  • Metformin (Glucophage): Glucophage is one of the miraculous drugs in metabolic syndrome. It helps control blood glucose in diabetics as well as their overall metabolism and has many benefits in those who have insulin resistant or “prediabetics”. It is the only medication in this list to target the liver and reduce fat accumulation independent on its effect on lipid levels. It also suppresses appetite and helps in losing weight in a natural way.
  • Statins: Statins are the most commonly used medications for abnormal lipid profile. They reduce the level of cholesterol which consequently reduces fat accumulation. Statins are, however, not recommended for all patients owing to their precautions and side effects. They are only used when aggressive reduction of blood fats is needed. You should never self-medicate with statins.
  • Some experimental medications including GLP-1 agonists can be used in some patients. However, they are not approved for cases of fatty liver disease yet. They are still only given to diabetics.

Written by Martin Davis