Ask the Expert: Impact of weight management on fatty liver

Written by Drs. Prowpanga Udompap, M.D., and Alina Allen, M.D.

Fatty liver disease is when fat deposition in your liver is more than normal.  Fatty liver can be caused by alcohol use.  However, more and more people develop it without alcohol use, which is called nonalcoholic fatty liver disease (NAFLD).  NAFLD has a broad disease spectrum.  Most patients have only simple steatosis (fat in the liver without causing any further issues).  However, up to a third of patients with simple steatosis would have significant inflammation, which could lead to liver fibrosis (scarring of the liver).

To date, there are no FDA-approved medications for the treatment of NAFLD.  To date, weight loss is the key to slowing the disease progression or even reversing the disease.

How much weight to lose?

• At least 3%-5% of baseline body weight can improve steatosis
• At least 7%-10% of baseline body weight can improve inflammation and scarring (fibrosis)

How to lose weight?

• The best way to sustain weight loss is with a daily caloric reduction of 500-1,000 kcal and moderate-intensity exercise.
• Among patients for whom lifestyle modifications do not yield significant weight loss results, further consultation with the weight management team, including the dietitian and endocrinologist, for additional fine-tuning of dietary modification and possible utilizing medications to help with weight loss.

Related posts:
Macronutrients and Weight Loss
Obesity and Heart Health
Do I still need to eat healthy and exercise when I'm on a weight loss medication?