Fatty liver living in adults

Overview

Fatty liver is a condition where fat builds up in your liver cells. In most cases, this is not caused by alcohol. If you have too much fat in your liver, it can sometimes lead to inflammation and scarring over time. The medical name for this is non-alcoholic fatty liver disease (NAFLD).

Yes, about 1 in 3 adults have some amount of fat in their liver. It is the most common liver condition in the UK and many other countries.

Fatty liver can affect anyone, but it is more common in people who are overweight or obese, have type 2 diabetes, high blood pressure, high cholesterol, or an unhealthy diet. It is also more common in people over 40.

Symptoms

Common symptoms

• Most people have no symptoms at all.
• Feeling tired or lacking energy.
• A dull ache or discomfort in the upper right side of the belly.

Symptoms in children

• Children may not have any symptoms either.
• Sometimes they may have stomach ache or feel more tired than usual.
• It is often found during check-ups for obesity or other health issues.

Symptoms in older adults

• Fatigue may be more noticeable.
• They may have other health conditions, like diabetes or heart disease, that make diagnosis trickier.
• Older adults may also have a higher risk of liver scarring.

Causes

Main causes

• Eating too much unhealthy fat and sugar, which leads to fat building up in the liver.
• Being overweight or obese, especially around the belly.
• Insulin resistance, which means your body cannot use insulin properly – a key link to type 2 diabetes.

Risk factors

• Having type 2 diabetes or pre-diabetes.
• High cholesterol or high triglycerides (a type of fat in your blood).
• High blood pressure.
• Rapid weight loss or very poor diet.
• A family history of fatty liver or liver disease.
• Certain medications (talk to your doctor).

When to see a doctor

See a doctor urgently if:

• If you have jaundice, severe belly pain, or confusion – call your local emergency number right away.
• If you have unexplained weight loss or swelling in your legs or belly, see a doctor the same day.

Book a routine appointment if:

• If you have ongoing tiredness, mild belly discomfort, or if you have risk factors like diabetes or obesity.
• If a routine blood test shows high liver enzymes, your doctor may want to investigate further.
• If you are worried about your liver health for any reason.

Diagnosis

Your doctor will ask about your health, lifestyle, and family history. They will also do a physical exam and order blood tests to check your liver. If those are abnormal, you may have an ultrasound or other scans to see fat in your liver.

Tests that may be done

• Blood tests: liver function tests, blood sugar, cholesterol, and other markers.
• Liver ultrasound: a painless scan that shows fat in the liver.
• FibroScan: a special ultrasound that measures liver stiffness to check for scarring.
• Liver biopsy (rarely needed): a tiny sample of liver taken with a needle to check for inflammation or damage.

What to expect at your appointment

Most tests are easy and quick. An ultrasound takes about 20 minutes. If you need a biopsy, you will be given a local anaesthetic and the procedure is done in hospital. Your doctor will explain what to expect and answer any questions.

Treatment

The main treatment for fatty liver is lifestyle change. There are no specific medicines to reverse the fat in your liver. Instead, treatment focuses on losing weight, eating well, and managing conditions like diabetes or high cholesterol. In severe cases, very advanced liver damage may need specialist care.

Self-care at home

• Lose 5-10% of your body weight if you are overweight – this can reduce liver fat significantly.
• Eat a healthy balanced diet – like the Mediterranean diet with lots of vegetables, fruit, whole grains, fish, and healthy fats.
• Avoid sugary drinks, sweets, and processed foods.
• Exercise regularly – aim for at least 30 minutes of moderate activity most days.
• Limit or avoid alcohol – even though the condition is not caused by alcohol, drinking can make it worse.
• Quit smoking if you smoke.

Medical treatments

There are no medicines approved specifically to treat the fat in the liver. However, your doctor may prescribe treatments for related conditions such as diabetes, high blood pressure, or high cholesterol. These can help reduce the risk of liver damage. Always take medicines as prescribed and discuss any side effects with your doctor. If you have other liver conditions, specialist treatments may be needed.

When is surgery considered?

In very rare cases where fatty liver leads to severe cirrhosis (scarring) and liver failure, a liver transplant may be considered. This is a major operation and only an option for a small number of people. Your doctor will refer you to a liver specialist if needed.

Living with this condition

Living with fatty liver usually means focusing on healthy habits every day. Many people feel better after just a few weeks of healthy eating and exercise. You may still have no symptoms, but it is important to keep up your changes to protect your liver.

Lifestyle tips

• Make a plan to lose weight gradually – a little bit each week.
• Cook more meals at home using fresh ingredients.
• Keep track of your blood sugar if you have diabetes.
• Stay active – find an activity you enjoy, like walking, swimming, or cycling.
• Get enough sleep and manage stress, which can affect your health.

Diet and exercise

Aim for a diet rich in vegetables, fruits, lean proteins (like chicken, fish, beans), and whole grains. Cut back on red meat, butter, fried foods, and sugary snacks. Drink plenty of water instead of soda or juice. Exercise helps burn fat and improves insulin sensitivity. Even a brisk 30-minute walk each day can make a big difference.

Mental health and emotional wellbeing

Being told you have a liver condition can be worrying. Some people feel anxious or down about their health. It may feel hard to change lifelong habits. Remember, you are not alone, and small steps count. If you feel overwhelmed, talk to your doctor or a mental health professional.

Prevention

Yes, in many cases fatty liver can be prevented by staying at a healthy weight, eating a balanced diet, exercising regularly, and managing conditions like diabetes and high cholesterol. Avoiding heavy alcohol use also helps protect your liver.

Vaccines

Getting vaccinated against hepatitis A and hepatitis B can help protect your liver from additional harm. Ask your doctor if these vaccines are right for you.

Screening programmes

There is no routine screening for fatty liver in the general population. However, if you have risk factors (such as obesity or diabetes), your doctor may check your liver with blood tests or an ultrasound as part of your regular care.

Complications

If left untreated

• The fat in your liver can cause inflammation, a condition called non-alcoholic steatohepatitis (NASH).
• Inflammation can lead to scarring of the liver (fibrosis) and eventually cirrhosis (severe scarring).
• Cirrhosis increases the risk of liver failure and liver cancer.

Long-term outlook

For most people, fatty liver does not cause serious harm. With the right lifestyle changes, you can reduce the fat in your liver, improve your overall health, and prevent it from getting worse. Even if you have some inflammation, weight loss often reverses it. Regular check-ups with your doctor will help you stay on track. The outlook is very good, especially if you take action early.

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