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What is fatty liver disease?

Fatty liver is a condition that is increasingly common in New Zealand and around the western world, as larger numbers of people are identified as overweight or obese. But there are other causes of the condition. Fatty liver is diagnosed when there is a build-up of fat within liver cells, and this happens when there is more fat entering the liver than what is leaving after processing.  


Fatty liver doesn’t have any symptoms for most people. It may just be that the liver is found to be enlarged through a physical examination by your doctor.  

Causes and complications
There are various causes of fatty liver, including: 
-    Being overweight/obese
-    Excess alcohol intake
-    Having a diet rich in processed foods and refined carbohydrates
-    Non-alcoholic fatty liver (NAFLD). This can be caused by other factors, such as diabetes, hepatitis C, raised cholesterol or increased triglyceride levels in the blood. Occasionally it can be caused by starvation, protein malnutrition or intestinal bypass operations
-    Belonging to a specific ethnic group (fatty liver is more common in Indians, Chinese, Maori and Pacific Islanders).

Fatty liver complications range from fat build-up causing inflammation of the liver, to scarring of the liver – called cirrhosis – which can change the liver’s structure and result in irreversible damage. In some cases it can also cause severe liver disease, liver failure and liver cancer. 

People with non-alcoholic fatty liver disease also have three times the risk of developing type two diabetes and double the risk of heart disease.


Fatty liver isn’t always easy to diagnose, and it may take a number of different tests to accurately determine its presence. Blood tests can detect abnormal liver enzymes. These are usually done after your doctor takes a detailed health history from you and completes a physical exam to detect any inflammation. Ultrasounds can identify fatty liver, but can miss up to 40 per cent of cases and have poor detection of scarring on the liver. A more accurate scan is called a Fibroscan, but this is not available in all regions. 

Often a combination of information from your health history and these test results will confirm a diagnosis of fatty liver disease. Treatment  

The best treatment for fatty liver is to prevent it from occurring. You should:
-    Gradually reduce body weight (ideally no more than 500g - 1 kg a week)
-    Eat a balanced, healthy diet and increase your physical activity
-    Lower triglycerides (calories stored in the body) through diet or medication, or both
-    Reduce alcohol consumption
-    Control your diabetes (if you have it)
-    Avoid starvation, excess dieting and protein malnutrition as this can also result in fatty liver.

There are no current medications to control fatty liver, but if you are diagnosed with the disease, the above preventative measures can help stop its progress. In severe cases, a liver transplant may be required.


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