How dangerous is a fatty liver (hepatic steatosis)?
For most people a fatty liver is stable for the time being, but it substantially raises the risk of cardiovascular disease, diabetes and liver disease; losing weight is so far the only proven way to limit the damage.
A fatty liver is by far the most common liver disease in the world: roughly one in four adults has it. In the United States the figure is almost one in three. Most people notice nothing at first, but the disease is anything but harmless. Cardiovascular disease is the most common cause of death in people with a fatty liver, not the liver itself. Cancer outside the liver ranks second. Liver disease comes only after that. This means a fatty liver puts the entire body at risk, even when the liver itself has not yet been seriously damaged. There is also a strong interaction with type 2 diabetes and chronic kidney disease: the conditions reinforce one another. In some people the fatty liver progresses to a more serious stage, one that involves inflammation and cell damage. Well over 66% of people above the age of 50 with diabetes or severe obesity already have such an advanced stage. Twenty percent of those with this more serious stage eventually develop liver cirrhosis, in which the liver consists largely of scar tissue. This is irreversible, and the condition is on track to become the most common reason for a liver transplant. Notably, liver cell cancer can also develop before cirrhosis is present, in up to half of NAFLD-related cases. The more scar tissue already present in the liver, the greater the risk of dying, both from liver disease and from other conditions. The severity of fibrosis is therefore the most important measure of prognosis. The only approach with proven effects on scar tissue formation is losing weight and adopting a healthier lifestyle. The more weight you lose, the greater the improvement. There is no approved medication specifically for a fatty liver. Some agents such as vitamin E or certain diabetes medications are being investigated, but their effect is modest and they have not been officially approved for this condition.
This answer is based on multiple systematic reviews and a meta-analysis. The meta-analysis covers dozens of studies on global prevalence and mortality figures. On most points the evidence is solid and consistent; the figures on progression to more serious stages are estimates with some uncertainty, because large long-term studies in humans are difficult to conduct and most data come from selected patient groups.
What is the link between fatty liver and type 2 diabetes?
Fatty liver and type 2 diabetes reinforce each other: they share the same underlying mechanism and roughly double each other's risk. If you have a fatty liver, addressing it is also a way to reduce your risk of diabetes.
Can you reverse liver fat accumulation and fibrosis?
Early liver fat accumulation and even fibrosis are largely reversible through weight loss of 10% or more. Start with a Mediterranean diet, resistance training and reduced alcohol intake, and discuss with your doctor whether medication is needed if lifestyle changes alone are not sufficient.
What is visceral fat and why is it more dangerous than subcutaneous fat?
Visceral fat is more dangerous than subcutaneous fat because it sends irritating substances and fatty acids directly to the liver, raising the risk of heart disease and diabetes regardless of your weight. Exercise and eating less help, and your waist circumference is a better indicator than the scales alone.
Does eating more fibre help against high blood sugar?
Water-soluble fibre from legumes, vegetables and fruit probably helps lower high blood sugar, but the overall composition of the meal also plays a role. For type 2 diabetes and gestational diabetes, consulting a doctor is always necessary.
How bad is sitting for too long for your blood sugar and metabolism?
Sitting for long uninterrupted periods noticeably impairs your blood sugar and metabolism, but short breaks of 2-3 minutes of movement every 20-30 minutes already undo a large part of that damage.
Does eating low-carb make a difference for belly fat?
Eating low-carb measurably reduces belly fat, especially if you are already overweight or have metabolic problems. Combining it with time-restricted eating works even better.