What is fatty liver disease—and is it reversible?

Fatty liver disease is a growing health concern. In the U.S., it’s estimated that one in four adults have a buildup of fat in the liver.  While it is normal to have a small amount of fat buildup in the liver, it can be concerning when it reaches over 5%-10% of your liver’s weight. This can potentially increase the risk of liver damage and, in some cases, cancer. Due to the negative stigma associated with the disease, as well as its complex metabolic roots, the terminology for fatty liver disease has evolved over time. It is now known as metabolic dysfunction-associated steatotic liver disease (MASLD), but it is also sometimes referred to as steatotic liver disease (SLD) or nonalcoholic fatty liver disease (NAFLD).
 

As MASLD progresses, the liver can become inflamed and damage can occur. When this happens, the disease is referred to as nonalcoholic steatohepatitis (NASH), now known as metabolic dysfunction-associated steatohepatitis (MASH).
 

Given the potential complications associated with fatty liver disease, it’s important to know how to properly manage the condition. But is it possible to reverse fatty liver disease through diet, exercise or other lifestyle changes?
 

First, let's look at the risk factors for fatty liver disease.
 

Fatty liver disease: Risk factors

There are several possible risk factors for developing fatty liver disease:

• Frequent or heavy alcohol use can lead to a type of liver disease called alcoholic liver disease (ALD)
• Metabolic syndrome  
• Type 2 diabetes
• Obesity
• Sleep apnea
• Polycystic ovary syndrome (PCOS)
• Hypothyroidism (low thyroid hormones)
• Certain prescription medications
   

In many cases, it is difficult to determine the cause of fatty liver disease. However, once you have a sense of whether fatty liver disease may be related to medication, lifestyle factors or an existing health condition, you can work with your healthcare provider on managing the condition more effectively.
 

Reversing fatty liver disease through lifestyle changes

Currently, there is only one FDA-approved medication for treating MASH and MASLD. Researchers continue to study other potential medications.
 

Healthy lifestyle changes—including weight loss, lowering cholesterol and triglycerides, managing diabetes and limiting alcohol intake—can all help control and possibly reverse fatty liver disease.
 

“Eating a diet high in fruits, vegetables, whole grains, legumes, nuts and olive oil, like the Mediterranean diet, can benefit your liver health,” says Irene Cheung, a family nurse practitioner and clinical lead at Labcorp OnDemand.