Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) as it is now referred to, is a liver condition affecting individuals with excess weight, obesity or other metabolic conditions like type 2 diabetes, hypertension or high cholesterol levels. In this disease, too much fat builds up in the liver.

Early warning signs of NAFLD

Fatty liver disease often doesn't manifest in symptoms. When present, signs include:

Abdominal pain or a feeling of fullness in the upper right sight of the belly.
Extreme exhaustion or weakness.
Feeling of being unwell, or malaise.

If the condition progresses to cirrhosis of the liver, one may experience:

Nausea.
Loss of appetite.
Unexplained weight loss.
Itchy skin.
Jaundiced skin and eyes.
Swelling in the abdomen, or ascites.
Enlarged spleen.
Swelling in limbs or oedema.
Bleeding from oesophagus, stomach or rectum.
Shortness of breath.
Spiderlike blood vessels just beneath the skin's surface.

Known risk factors for NAFLD

Obesity, particularly in the midriff.
Type 2 diabetes.
High cholesterol count.
High levels of triglycerides in the blood.
Insulin resistance.
Metabolic syndrome.
Polycystic ovary syndrome.
Obstructive sleep apnoea.
Underactive thyroid, or hypothyroidism.
Underactive pituitary gland.
Growth hormone deficiency.

Treatment options for fatty liver disease

There is no defined treatment or medication for fatty liver disease, and doctors primarily concentrate on helping you control your risk factors for the condition, mainly lifestyle changes.

You might be advised to:

Avoid alcohol: Stay away from the bottle, even if your fatty liver disease isn't triggered by alcohol.
Shed weight: Following an exercise regimen, diet correction under the supervision of a nutritionist and certain medications can help with weight loss. For extremely obese individuals, bariatric surgery could be an option.
Manage metabolic conditions with meds: Take prescribed medicines to manage conditions like diabetes, high cholesterol and triglycerides.
Get vaccinated for hepatitis A and hepatitis B: If you already have liver disease, these viral infections could be even more dangerous.

Is fatty liver disease a serious issue?

While in most cases, the fat buildup doesn't lead to serious issues or affect liver function, in few people, the condition progresses to liver disease. This progression happens in stages:

Hepatitis: This is when the liver becomes inflamed and damages tissue, a stage referred to as steatohepatitis.
Fibrosis: In this stage, bunches of scar tissue form at the site where the liver is damaged by inflammation. This leads to stiffening of the liver.
Cirrhosis: This is a serious condition where healthy tissue is replaced by scar tissue. Without proper treatment, cirrhosis can even lead to liver failure and liver cancer. Nearly 90% of people who develop a type of liver cancer called hepatocellular carcinoma, have cirrhosis.