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July 1, 2019

My Doctor Told Me I Have Fatty Liver—What Do I Need to Know?

Author Affiliations
  • 1Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
  • 2Division of Gastroenterology, Department of Medicine, UCLA–Olive View Medical Center, Los Angeles, California
JAMA Intern Med. 2019;179(9):1308. doi:10.1001/jamainternmed.2019.1240

What Is Nonalcoholic Fatty Liver Disease?

Nonalcoholic fatty liver disease (NAFLD) is a condition where fat builds up in the liver, leading to inflammation and liver injury. Often referred to as fatty liver, NAFLD is common and affects about 25% of people in the world. It is not caused by alcohol, medications, or infections.

What Are Risk Factors for NAFLD?

Obesity is the most common risk factor for NAFLD. Some people develop NAFLD even though they do not have any risk factors.

How Is NAFLD Diagnosed?

Nonalcoholic fatty liver disease is usually discovered incidentally when tests for liver function are completed for unrelated conditions. Additional testing may be recommended to confirm NAFLD and rule out other causes of liver disease. Nonalcoholic fatty liver disease may progress to cirrhosis, which is scarring of the liver. Symptoms may include reduced concentration, forgetfulness, sleepiness, and confusion.

Are There Effective Treatments for NAFLD?

Nonalcoholic fatty liver disease is a treatable and potentially reversible condition. Treatment focuses on weight loss and maintaining a healthy weight. Lifestyle changes such as choosing healthy foods, exercise, and weight loss are the most effective treatment for NAFLD.

  • For overweight individuals, losing 10% of body weight has been shown to reduce the amount of fat in the liver and to reduce inflammation.

  • A low-calorie, low-fat diet, such as the Mediterranean diet, can potentially reduce the amount of fat in the liver.

  • Avoiding foods and drinks that are high in fructose, such as sugar-sweetened soda, juice, and sweets, might reduce the risk for developing NAFLD and reduce the amount of fat in the liver.

  • Individuals with NAFLD should take part in more than 150 minutes of exercise per week or increase the amount they exercise by more than 60 minutes.

  • Alcohol should not be consumed in heavy amounts.

    • For men, heavy alcohol use is defined as more than 4 alcoholic drinks on any day or 14 drinks per week.

    • For women, heavy alcohol use is defined as more than 3 alcoholic drinks on any day or 7 drinks per week.

  • Bariatric surgery is an option for individuals who are unable to lose weight with diet and lifestyle changes. Bariatric surgery is a type of surgery that can help some people lose weight by making changes to their digestive system.

  • Individuals with NAFLD should be vaccinated against hepatitis A and B if they are not already immune.

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Section Editor: Michael Incze, MD, MSEd.
The JAMA Internal Medicine Patient Page is a public service of JAMA Internal Medicine. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Internal Medicine suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: July 1, 2019. doi:10.1001/jamainternmed.2019.1240

Conflict of Interest Disclosures: None reported.