Controlling fatty liver disease starts with weight loss
Danielle Dawson, 44, was shocked to learn in July 2020 that she had fatty liver disease. The hairdresser and married mother of three in Sandwich, Illinois, expected her doctor to tell her that the pain she had in her right side was due to problems with her gallbladder or digestive system. “It never occurred to me that it would be my liver,” Dawson says.
For one thing, she associated liver problems with heavy drinking. But Dawson was only an occasional social drinker. “I think to myself, wait a minute: I don’t really drink a lot of alcohol. So how is it going? »
Photo by Taylor Oak Photography
She also didn’t consider herself particularly overweight – at 181 pounds on a 5ft 7in frame – which would put her at increased risk of contracting the disease.
Yet her doctor explained that she has non-alcoholic fatty liver disease (NAFLD), a condition in which fat builds up in the liver. The disease put her at risk of developing cirrhosis or scarring of the liver. And the cirrhosis could mean she would need a liver transplant or could even die.
“I thought, ‘Holy shit!’ It scared me. It’s my health, and I have to do what I can to improve it,” says Dawson.
The Dangers of Fatty Liver Disease
Dawson isn’t the only person feeling stunned by a diagnosis non-alcoholic fatty liver disease, which many people are unaware of, although it is relatively common.
About 25% to 30% of Americans over the age of 15 — more more than 80 million people – suffer from non-alcoholic fatty liver disease, according to a 2017 study by the Center for Disease Analysis, a public health company that studies disease. Scientists predict that at least 100 million people will be diagnosed by 2030, a number that is rising with the rate of obesity in the United States.
It is important to catch non-alcoholic fatty liver disease early, before the damage is irreversible. People can reverse the disease or control it by losing weight.
“I think to myself, wait a minute: I don’t really drink a lot of alcohol. So how is it going? »
There are several stages in the progression of the disease. When fat builds up in the liver where it shouldn’t be, the diagnosis is NAFLD.
When there is also inflammation and damage to the liver, the condition is called non-alcoholic steatohepatitis, or NASH. About 25% of people with NAFLD develop NASH. In this subtype, the liver is inflamed and “the development of scarring is already beginning,” says Mary Rinella, MD, a gastroenterologist who leads the metabolism and fatty liver disease program at University of Chicago Medicine.
People with NASH are at an increased risk of developing cirrhosis, a serious condition that involves scarring and permanent liver damage. When scar tissue takes up more of the liver, it is harder for the liver to remove toxins from the blood and process nutrients.
As cirrhosis progresses, the liver struggles to function, making a transplant the only recourse.
When the liver is “completely healed, there is no cure,” says Kavita Singh, MD, division chief of gastroenterology for NorthShore University Health System. “You talk about liver transplantation and a complete downward spiral in people’s quality of life.”
Cirrhosis can also lead to liver cancer. Also, says Rinella, fatty liver disease increases the risk of developing non-hepatic cancers, such as colon or kidney cancer, and cardiovascular disease.
What You Can Do About Fatty Liver Disease
Not everyone who is overweight or obese develops fatty liver disease. However, obesity — especially excess weight in the belly, called visceral fat — and conditions such as diabetes and hypertension lead to fatty liver disease, Rinella says.
“Eating excess calories causes fat build up in the liver,” says Rinella. “When the liver doesn’t process and break down fat the way it normally should, too much fat builds up.”
Fatty liver can also occur without obesity, although it’s less common, Singh says. Other causes include genetics and various medical conditions, such as sleep apnea, hypothyroidism, and autoimmune disorders.
While NAFLD is more common in men in general, the disease accelerates in women after menopause due to hormones and other factors, Rinella says.
Early detection of fatty liver disease is tricky. “A lot of people don’t have any symptoms,” Singh says.
Dawson was blessed with pains that revealed his condition. Doctors often only discover the disease incidentally, during routine blood tests. or tests for other problems.
“We need more awareness at all levels,” says Rinella, calling for more public education and screenings.
No drugs are currently approved by the Food and Drug Administration for fatty liver disease. However, with over 200 clinical trials underway and several drugs in late-stage development, it is highly there will probably be an approved drug for the NAFLD in the next few years,
said Rinelle. She advises people with liver scarring to request a clinical trial to access these drugs.
Weight loss is the primary way to fight fatty liver disease, Singh says. Lose 7% to 10% of your body weight can reduce the liver fat, inflammation and scars.
Some obese people may choose bariatric surgery. If they can keep the weight off, it can reverse NAFLD or NASH, Rinella says.
It is also important to control diabetes, cholesterol and blood pressure, as these conditions promote fatty deposits in the liver or worsen existing fatty liver disease.
A healthy diet is also essential. Dawson took his doctor’s advice and started eating more whole grains and vegetables, while avoiding red meat, fried foods, sugar and sodium. She ditched her daily Mountain Dew in favor of water and black coffee. She quit booze and took up Pilates. In seven months, she lost 45 pounds.
Dawson still has work to do, however. Her liver function tests did not improve as much as she had hoped, possibly due to an autoimmune thyroid disease which may be contributing to her liver disorder.
Discouraged by this lack of progress, Dawson says she went off the diet for a week and then realized how much more physical and mental energy she had while on her healthy diet.
Now Dawson says she can’t imagine going back to her old lifestyle. “I have to stick with it. I feel so much better,” she says. She’s not just protecting her liver, she’s protecting her life.
Originally published in Spring/Summer 2022 printing problem.
Lorna Collier is a health and education writer whose articles have appeared in the Chicago Grandstand, Next avenue, USNews.com and many more.
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