Let’s talk about your liver. You may not think about it often, but it’s one of the hardest-working organs in your body. It helps clean your blood, breaks down food, stores energy, and even helps you fight off sickness. But when too much fat builds up inside your liver, that’s a problem. This is called fatty liver disease, and it’s something millions of people have — even if they don’t know it.
Fatty liver disease happens when fat makes up more than 5% of your liver. Some people get fatty liver from drinking too much alcohol. But many others get it without drinking at all. That’s called non-alcoholic fatty liver disease. Today, doctors use a new name for this: MASLD, which stands for metabolic dysfunction-associated steatotic liver disease. That’s a long name, but don’t worry — we’re going to break it down in a way that makes sense.
So how do you end up with a fatty liver? One of the biggest reasons is being overweight or having obesity. When you carry too much fat on your body — especially around your belly — that fat can start to collect in your liver. It’s like stuffing too many clothes into a suitcase. Eventually, things get too packed in there, and your liver can’t work like it’s supposed to.
Another cause is eating a diet high in sugar, junk food, and unhealthy fats. Drinking sugary sodas, eating lots of fried food, and skipping fruits and vegetables can all lead to fat building up in the liver. Not moving enough is another problem. If you sit most of the day and don’t get regular exercise, you’re more likely to develop fatty liver.
Some people get fatty liver even if they’re not overweight. That can happen if you have other health conditions, like type 2 diabetes, high blood pressure, or high cholesterol. These problems often go together and are part of something called metabolic syndrome. When your body can’t handle sugar well — which is what happens with insulin resistance — fat starts to collect in places it shouldn’t, like your liver.
There are also things like sleep apnea, where your breathing stops and starts during sleep, that can make fatty liver worse. And even your genes can play a part. If someone in your family has liver disease, you might be more likely to get it, too.
You might be wondering, how do I know if I have fatty liver? That’s the tricky part. Most people don’t feel sick at all. You might feel tired, or notice a little pain or heaviness in your upper belly, but that’s about it. Doctors usually find fatty liver by doing blood tests or looking at your liver with an ultrasound. Sometimes, they’ll need to take a tiny sample of your liver — called a biopsy — to see how much fat or damage there is.
The good news? If fatty liver is caught early, it can be reversed. But if it’s not treated, it can get worse over time. When fat in the liver leads to swelling and damage, it’s called MASH — metabolic dysfunction-associated steatohepatitis. That’s a fancy word for a liver that’s not just fatty, but also inflamed and starting to scar. If the scarring gets bad enough, it turns into cirrhosis. That’s when your liver gets hard, lumpy, and stops working well. At that point, you might need a liver transplant to survive.
Fatty liver doesn’t just hurt your liver — it can affect your whole body. People with fatty liver disease are more likely to have heart attacks and strokes. That’s because fat in the liver often means fat in the blood vessels too. Your liver helps manage your cholesterol, so when it’s not working right, your cholesterol can go up and damage your heart. Fatty liver can also lead to type 2 diabetes, or make it worse if you already have it. And if your liver becomes very sick, it can affect your kidneys, your brain, and even your bones.
So what can you do if you have fatty liver — or want to prevent it? The best treatment is not a pill. It’s a change in your daily habits. The number one thing you can do is lose weight, if you need to. Even losing just 5% to 10% of your body weight can take a lot of fat out of your liver. That might not sound like much, but it can make a big difference. For example, if you weigh 200 pounds, losing just 10 to 20 pounds can help heal your liver.
Eating healthy food is also key. Try to eat more fruits, vegetables, whole grains, beans, and fish. Cut back on sugar, white bread, soda, and fried food. Look for healthy fats, like those found in olive oil, nuts, and avocados. The Mediterranean diet is a great way to eat if you have fatty liver. And believe it or not, drinking coffee — without too much cream or sugar — might actually help protect your liver.
Exercise is another important step. You don’t have to run marathons. Even walking 30 minutes a day, five times a week, can make a difference. Try to move your body more and sit less. If you have trouble getting started, ask your doctor or a physical therapist for help.
If you drink alcohol, cutting back or quitting altogether is a must. Even a little alcohol can harm a liver that already has fat in it. Some medicines can also hurt your liver, especially if you take too much. Always follow the directions for pain relievers like acetaminophen, and let your doctor know about all the medications and supplements you take.
Some people ask, “Is there a pill I can take to fix this?” Right now, there’s no magic medicine for fatty liver. But if your liver has already started to scar — what doctors call MASH — there’s a new medicine called Rezdiffra that might help. It works by lowering the fat and inflammation in the liver. Your doctor can tell you if this medicine is right for you. But for most people, the best way to treat fatty liver is with healthy lifestyle changes.
You might also hear about vitamin E or other supplements helping the liver. Some studies show that vitamin E can help people with fatty liver, but it’s not safe for everyone. It may raise the risk of prostate cancer in some men, so you should always talk to your doctor before taking it.
One thing that doesn’t help? Feeling ashamed or guilty. A lot of people with fatty liver blame themselves. But this is a medical condition, just like high blood pressure or diabetes. It’s not about being lazy or making bad choices. It’s about how your body handles fat, sugar, and insulin. And while you can’t change your genes, you can take steps to care for your liver and your overall health.
If your liver becomes very damaged and stops working, a liver transplant may be your only option. That means getting a new liver from a donor. Transplants are serious, and not everyone qualifies. But many people do well after a transplant and go on to live full, healthy lives.
After a transplant, you’ll need to take special medicines to stop your body from rejecting the new liver. You’ll also need to keep eating healthy, exercising, and seeing your doctor regularly. Sometimes, fatty liver disease can come back even after a transplant. That’s why it’s important to keep taking care of yourself, even if your liver is brand new.
Living with fatty liver can feel overwhelming. But remember, most people with this condition get better with the right care and support. You’re not alone. Millions of others are working on making healthy changes, just like you. Talk to your doctor, ask questions, and take one step at a time. Whether it’s a short walk after dinner or swapping chips for an apple, every small change helps.
Your liver does so much for you every day. It’s time to return the favor. Be kind to it. Fuel it with good food, move your body, and keep your health a top priority. You only get one liver — so let’s take care of it together.