Fatty Liver Disease: Causes, Symptoms & Treatment Options

Published on: 1 July 2025

Introduction

Fatty liver disease is quickly becoming one of the most common health issues across India, especially in urban areas where sedentary lifestyles and high-calorie diets dominate. Fatty liver, also known as hepatic steatosis, occurs when excess fat accumulates in the liver. It might sound harmless, but over time it can lead to severe liver damage, including cirrhosis and liver cancer. Fortunately, with early diagnosis and targeted lifestyle changes, fatty liver is often reversible.

There are two main types of fatty liver:

Non-Alcoholic Fatty Liver Disease (NAFLD): The more common form, not linked to alcohol consumption.
Alcoholic Liver Disease (ALD): Caused by excessive alcohol intake.

Let’s explore everything from causes and symptoms to diagnosis and treatment options for fatty liver, with a special focus on how to manage the condition in the Indian context.

What is Fatty Liver Disease?

Fatty liver disease is a condition where more than 5% to 10% of the liver's weight is made up of fat. While a healthy liver contains a small amount of fat, excessive accumulation may affect its ability to function. There are two broad types:

NAFLD (Non-Alcoholic Fatty Liver Disease): Occurs in people who consume little or no alcohol.
- Simple fatty liver (steatosis): Fat accumulation without inflammation or liver cell damage.
- NASH (Non-Alcoholic Steatohepatitis): Fat accumulation along with inflammation and liver cell damage.
ALD (Alcoholic Liver Disease): Caused by heavy alcohol consumption, leading to inflammation, fat build-up, and scarring.

According to a 2020 study published in the Journal of Clinical and Experimental Hepatology, the prevalence of NAFLD in the Indian population is estimated at 30% to 40%, especially in individuals with obesity, diabetes, or metabolic syndrome.

Is Fatty Liver Dangerous?

At first, fatty liver might seem like a benign condition. However, over time, if not managed, it can lead to serious complications. Fatty liver progresses through the following stages:

Simple steatosis: Fat in the liver with little or no inflammation.
NASH: Inflammation and damage to liver cells.
Fibrosis: Formation of scar tissue due to ongoing inflammation.
Cirrhosis: Extensive scarring that impairs liver function.
Liver Cancer (Hepatocellular Carcinoma): May develop in some individuals with long-standing cirrhosis.

Early diagnosis is essential to prevent irreversible damage. Learn more about related conditions like acid reflux that may co-exist with fatty liver.

What Causes Fatty Liver?

Fatty liver develops when the liver cannot efficiently break down fats, causing them to accumulate in liver cells. Common causes include:

Obesity: Especially abdominal or visceral fat.
Type 2 Diabetes and Insulin Resistance
High Cholesterol and Triglycerides
Poor Diet: Excess refined carbs, sugar, fried foods, processed foods.
Sedentary Lifestyle
Excessive Alcohol Consumption
Medications and Genetic Factors

Even people with a normal BMI (commonly seen in India) can develop fatty liver due to "thin-fat" phenotype: low muscle mass with high body fat percentage.

ALD vs NAFLD: What's the Difference?

While both conditions involve fat accumulation in the liver, the cause differs:

ALD: Triggered by alcohol intake over 20g/day in women and 30g/day in men.
NAFLD: Occurs in people who drink little or no alcohol. Driven by metabolic issues.

Treatment differs too:

For ALD, complete abstinence from alcohol is essential.
For NAFLD, lifestyle management plays a larger role.

What are the Symptoms of Fatty Liver?

Most people with fatty liver don’t experience symptoms, especially in early stages. As the disease progresses, symptoms may include:

Persistent fatigue or weakness
Mild discomfort or pain in the upper right abdomen
Unexplained weight loss
Loss of appetite
Nausea
Jaundice (yellowing of skin/eyes, in advanced stages)
Swelling in legs or abdomen (in cirrhosis)
Mental confusion (hepatic encephalopathy in late stages)

When to See a Doctor?

Consult a liver specialist if you have risk factors like obesity, diabetes, or a family history of liver disease. Early detection can prevent progression to irreversible stages.

How is Fatty Liver Diagnosed?

Diagnosis usually involves a combination of:

Physical Examination: Doctors may detect an enlarged liver.
Blood Tests: Elevated liver enzymes (ALT, AST) may indicate inflammation.
Ultrasound: A non-invasive method to detect fatty deposits.
FibroScan: Measures liver stiffness to assess fibrosis.
CT or MRI Scans
Liver Biopsy: Rare, unless diagnosis is uncertain.

Modern tools like FibroScan and MR elastography are highly effective for early diagnosis. Bangalore Gastro Centre offers these non-invasive options.

What to Eat for Fatty Liver?

Diet is one of the most effective tools to reverse fatty liver. The Mediterranean-style diet is ideal:

Foods to Include:

Leafy greens, cruciferous vegetables
Berries, apples, oranges
Whole grains: brown rice, oats, millets
Legumes: lentils, rajma, chana
Lean proteins: fish, egg whites, tofu
Healthy fats: nuts, seeds, olive oil
Low-fat dairy: curd, paneer

Foods to Avoid:

Refined carbs: white rice, white bread
Sugar: sweets, cold drinks, packaged juices
Fried foods: pakoras, samosas
Red/processed meats: sausages, bacon
Alcohol: Even moderate drinking can worsen fatty liver

A simple Indian meal plan may include:

Breakfast: Moong dal chilla + curd
Lunch: Brown rice + mixed veg curry + dal + salad
Snack: Handful of almonds + coconut water
Dinner: Grilled paneer + sautéed spinach + roti made with bajra/jowar

Stay hydrated and avoid sugar-sweetened beverages.

How to Reverse Fatty Liver Naturally

Weight Loss: Losing 7-10% of body weight can significantly reduce liver fat.
Exercise: Aim for 30–45 minutes daily.
Healthy Diet
Control Diabetes & Cholesterol
Avoid Alcohol & Tobacco
Monitor Progress: Follow-ups with ultrasound or FibroScan

Finally, check out how heartburn and fatty liver sometimes go hand-in-hand in our blog on Acid Reflux & GERD.

Medical Treatment for Fatty Liver

Currently, there are no FDA-approved drugs specifically for NAFLD or NASH in India. However, the following may be prescribed:

Vitamin E: For non-diabetics
Pioglitazone: For diabetic NASH
GLP-1 agonists (e.g., semaglutide)
SGLT2 inhibitors
Resmetirom: Approved in the US, pending in India

Note: These should only be taken under medical supervision.

Procedures in Advanced Cases

Bariatric Surgery: For obese patients where diet and exercise fail
Liver Transplant: For liver failure or decompensated cirrhosis

Prevention of Fatty Liver Disease

Maintain a healthy weight
Exercise regularly
Eat balanced, home-cooked meals
Avoid binge drinking
Regular health check-ups if diabetic, obese, or have high cholesterol

Want to know how constipation impacts liver function? Read our Constipation Guide.

FAQs

Q1. Can fatty liver be cured?
Yes. In early stages, lifestyle changes can reverse it completely.

Q2. Is it OK to drink coffee?
Yes. Black coffee (2–3 cups/day) is shown to lower risk of fibrosis.

Q3. What about milk and curd?
Low-fat milk and curd are good sources of protein and calcium.

Q4. Do I need to stop eating rice?
Switch to brown rice or millets. Avoid large portions of white rice.

Q5. Can children have fatty liver?
Yes. Rising childhood obesity in India is increasing NAFLD rates in kids.

To Sum Up

Fatty liver is a rising health concern, especially in Indian urban and semi-urban populations. Thankfully, early-stage fatty liver is completely reversible with dietary changes, exercise, and weight loss. If you’re struggling with belly fat, high cholesterol, or diabetes, it’s worth getting your liver checked.

Bangalore Gastro Centre offers expert consultation and non-invasive liver screening techniques.

For tips on healing naturally, don’t miss our Fatty Liver Reversal Tips Blog.