Fatty Liver Disease (NAFLD)
مرض الكبد الدهني غير الكحولي
A build-up of excess fat in the liver not caused by alcohol, closely linked to obesity, insulin resistance, and metabolic syndrome. Early stages often cause no symptoms and are found incidentally on an ultrasound or blood test, but the condition can progress to liver inflammation and scarring if untreated. Weight loss — including through bariatric surgery — is the most effective treatment for reversing it.
This information is for general awareness only and does not replace professional medical advice. Consult a doctor for diagnosis and treatment.
Quick answer
Non-alcoholic fatty liver disease (NAFLD) is a build-up of fat in the liver in people who drink little or no alcohol. It is very common and closely linked to overweight, type 2 diabetes and high cholesterol.
Most people have no symptoms. Some feel tired or have mild discomfort in the upper right abdomen. In some, the fat causes inflammation (steatohepatitis) that can lead to scarring (fibrosis) and, over years, cirrhosis.
It is often found on ultrasound or abnormal liver tests. There is no single approved cure; the main treatment is weight loss, healthy eating and activity, and controlling diabetes, blood pressure and cholesterol, with follow-up to check for liver scarring.
Symptoms
Often no symptoms
It is frequently discovered by chance on a scan or blood test.
Tiredness
Mild discomfort or fullness in the upper right abdomen
Enlarged liver
Sometimes found by a doctor on examination.
Signs of advanced liver disease
Yellowing of skin and eyes (jaundice), swelling of the legs or abdomen, easy bruising, itching — mainly when scarring is advanced.
Symptom guides
Causes and risk factors
Causes
- Insulin resistance and excess body weight — Extra fat and insulin resistance promote fat build-up in liver cells.
- Metabolic conditions — Type 2 diabetes, high cholesterol and triglycerides, and high blood pressure often occur together with it.
- Other contributors — Rapid weight loss, certain medicines, and genetic factors can play a role.
Risk factors
- Overweight or obesity, especially around the waist
- Type 2 diabetes or prediabetes
- High cholesterol or triglycerides
- High blood pressure
- Polycystic ovary syndrome and sleep apnoea
- Older age and family history
How is it diagnosed?
Diagnosis confirms fat in the liver, excludes other causes such as alcohol or viral hepatitis, and assesses whether there is scarring.
Liver function tests
May show raised liver enzymes, though they can be normal.
Ultrasound
Often the first imaging test to show fat in the liver.
Excluding other causes
Alcohol history, viral hepatitis tests and review of medicines.
Assessing scarring (fibrosis)
Blood-based scores, FibroScan elastography, and occasionally a liver biopsy.
Related tests
Treatment
The mainstay is lifestyle change, with control of related conditions. Medicines for the liver itself are limited, and the plan is set by your doctor or a liver specialist.
Gradual weight loss
Losing a modest percentage of body weight can reduce liver fat; larger losses can reduce inflammation and scarring.
Healthy eating
A balanced, plant-rich eating pattern; limiting sugary drinks, refined carbohydrates and processed foods.
Regular physical activity
Controlling related conditions
Treating diabetes, cholesterol and blood pressure as advised.
Avoiding alcohol and liver-harming substances
Discuss safe limits and medicines with your doctor.
Regular follow-up
Monitoring for scarring, with specialist referral if it is suspected.
Avoid unproven 'liver detox' products and rapid crash diets, which can be harmful.
When should you see a doctor?
Arrange a medical assessment if
- Abnormal liver tests or fatty liver on a scan — ask about follow-up
- Persistent tiredness or upper-right abdominal discomfort
- You have diabetes, obesity or high cholesterol and have never had your liver checked
- Unexplained weight loss or loss of appetite
Seek urgent care if
- Yellowing of the skin or eyes
- Vomiting blood or black stools
- Confusion or unusual drowsiness
- Rapid swelling of the abdomen or legs
Prevention
Maintain a healthy weight
Eat a balanced diet
Fewer sugary drinks and processed foods; more vegetables, fruit, whole grains and healthy fats.
Be physically active regularly
Control diabetes, cholesterol and blood pressure
Limit alcohol
Frequently asked questions
What is fatty liver disease?
A condition in which excess fat builds up in the liver. When it is not caused by alcohol it is called non-alcoholic fatty liver disease (NAFLD).
Does fatty liver cause symptoms?
Usually not. It is often found by chance on an ultrasound or blood test.
Is fatty liver dangerous?
In many people it stays mild, but in some it progresses to inflammation, scarring and cirrhosis, which is why follow-up matters.
Can fatty liver be reversed?
Early fatty liver often improves or resolves with weight loss, healthy eating and exercise.
How is fatty liver diagnosed?
With blood tests, an ultrasound, and further tests such as elastography to assess scarring.
Can I have fatty liver if I don't drink alcohol?
Yes. NAFLD occurs in people who drink little or no alcohol and is linked mainly to metabolic factors such as weight and diabetes.
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Medical sources
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