Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than 5% – 10% percent of the liver’s weight is fat, then it is called a fatty liver (steatosis). Folks who drink alcohol regularly can also develop fatty liver disease, either because of excess carbohydrates consumed (especially beer and sweetened mixed drinks) or excessive alcohol intake when the liver converts the alcohol into fat in the liver cells. In addition, the disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome.

The risk of  NAFLD increases with weight and the folks at highest risk are most likely to have the disease. NAFLD is a serious risk factor for Non-alcoholic steatohepatitis  (NASH) which occurs when the liver becomes inflamed by inflammation stimulating chemicals produced by the fat cells. Experts estimate that 40% of the adult population has fatty liver disease and 3% of the population has NASH. Of the very obese, about 25% have NASH. Approximately 20% of patients with NASH will develop cirrhosis over a 20 year period ultimately requiring liver transplant. Doing the math, 0.6% of the present population is expected to develop cirrhosis over the next 20 years. that is nearly TWO MILLION people. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States.

Cleveland Clinic’s excellent discussion of NAFLD and NASH is located here.

The National Institute of Health discusses NASH here.

The treatment for fatty liver disease is aggressive weight loss to ideal body weight levels.

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