Fatty liver: the newest metabolic epidemic

Ten years ago, no one thought about the consequences of having fat in your liver. In fact, tons of people were labeled with “cryptogenic” cirrhosis or cirrhosis of unknown etiology because we had no idea fat could cause such harm. Now we know basically all of those cirrhosis cases were due to metabolic syndrome and fatty liver, officially referred to as nonalcoholic fatty liver disease (NAFLD). Fast forward to today, and fatty liver is the biggest, most worrisome liver condition out there and has already surpassed hepatitis C as the top top reason adults are listed for liver transplant.

How big is this problem, you ask? It is THE most common liver disorder in Western industrialized countries, where the risk factors for fatty liver are all too common. In fact, in the U.S., up to almost 50% of patient have fatty liver. HALF of the country!

The reason this is a BIG DEAL is because fat in the liver may lead to bad consequences including:

- Cirrhosis (end stage liver disease), especially in people with diabetes, abnormal liver tests, overweight/obesity, heavy alcohol use

- Liver cancer: the risk of cancer among those with cirrhosis was12.8% over 3 years

- Increased risk of death and cardiovascular disease

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So know the risk factors and protect your liver from fat! Excess calorie intake, unhealthy diet, and physical sedentariness remain the main drivers of NAFLD, modulated by gene/behavior interaction.

- Central obesity (“apple shape”)

- Type 2 diabetes

- High triglycerides or low HDL (“good” cholesterol)

- High blood pressure

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But if you are one of the millions of people in the U.S. that end up getting diagnosed with fatty liver, then this is one of the few diseases in medicine that you can really turn around WITHOUT MEDICATION! Here's the treatment plan:

1. Lose weight!

- If you are overweight or obese (BMI>25 kg/m2), THIS is your motivation to lose weight!

- Weight loss & increased physical activity leads to sustained improvement in liver tests, liver disease stage, insulin levels, and quality of life in patients withfatty liver

- A 5% reduction in BMI is accompanied by 25% reduction in liver fat on MRI, up to complete normalization of liver triglycerides in a few weeks

- Lose 1-2lbs/wk (rapid weight loss is dangerous!)

- Use all your tools! Diet, exercise, medications, bariatric therapies including intragastric balloons, incision-less sleeve gastroplasty...

2. Vaccinate!

- Protect your liver from other liver diseases such as hepatitis A & B

3. Prevent cardiovascular disease- the risk is high!

- Optimize blood sugar control in diabetes, treat high cholesterol, talk to your doctor!

4. Avoid alcohol

- Swap out cocktails for mocktails and instead enjoy some liver health!

-Check out this awesome NYTimes article "These Drinks Have a Secret" with tips

So talk to your doc if you're suspicious you may be harboring fat in your liver-- there's A LOT you can do to prevent & reverse it! #gutlove