Fatty Liver Disease Management, Medications, and Treatment Options

If you or a loved one was recently diagnosed with nonalcoholic fatty liver disease (NAFLD), you might be wondering how it’s treated. Unfortunately, there aren’t any medications approved for specifically treating NAFLD. Instead, your doctor will recommend a combination of lifestyle modifications you can make to help reduce the fat content in your liver. Managing other underlying health conditions that contribute to NAFLD can also help you better control your disease.

Lifestyle Modifications for NAFLD

The mainstay in nonalcoholic fatty liver disease treatment is making lifestyle changes that help you lose weight. It’s best to aim for losing 10 percent of your body weight, but research shows that even losing 3 to 5 percent can help treat NAFLD. While this may seem like a daunting task, you’ll be surprised at how helpful making just a few small changes can be.1

While you may be able to lose weight by either dieting or exercising alone, studies have found that doing both produces better long-term results.2 Taking these steps to treat your NAFLD can also help prevent nonalcoholic steatohepatitis (NASH), a more severe form of NAFLD that causes liver scarring and damage.

Eat a Healthy Diet

NAFLD is caused by a buildup of extra fat in the liver — by watching what you eat, you can slow it and sometimes even reverse it.3,4 People who have diabetes or are overweight or obese are more likely to have NAFLD caused by poor diet choices. They’re also more likely to have high blood sugar, cholesterol, and triglyceride levels, all of which can increase inflammation and liver fat.

Your diet plays an extremely important role in your overall health. Everything you eat is broken down by your body and used for energy. However, if you eat excess calories or foods high in sugar or fat, your body may store them in unhealthy ways. For example, extra calories are turned into triglycerides, a certain type of fat — your body then stores these fats in your cells for later use. If you continue to eat a high-calorie diet, you’ll continue creating fat stores you don’t need, especially in the liver.5,6

Your doctor may recommend meeting with a registered dietitian to help you develop a healthy eating plan. Many of these recommendations also help people living with diabetes and those who are overweight or obese. Suggestions your dietitian may make include:4

  • Eating foods that are less likely to spike your blood sugar levels (known as low-glycemic foods), such as whole grains, fruits, and vegetables7
  • Limiting high-glycemic index foods (foods that are more likely to spike your blood sugar), such as potatoes, white rice, and white bread
  • Limiting food and drink made with fructose or white sugar (which is broken down into glucose and fructose); these sugars are often found in juices, sodas, sports drinks, and sweetened teas
  • Choosing low-sugar or sugar-free food and drinks, such as diet beverages and sugar-free snacks
  • Limiting your fat intake, as fats are high in calories and can contribute to weight gain; try to limit fried foods and red meats
  • Adding more lean proteins to your diet, such as chicken, turkey, low-fat dairy, and tofu
  • Choosing unsaturated fats in place of trans fats and saturated fats; one example is omega-3 fatty acid (found in fatty fish, walnuts, and soybeans), which helps lower your risk of heart disease while living with NAFLD
  • Limit your alcohol intake, as alcohol can contribute to inflammation and fatty liver disease

Studies also show that drinking coffee can help lower the risk of NAFLD. Coffee contains antioxidants and vitamin E, which may help reduce liver scarring (fibrosis) and inflammation.8 Try enjoying a cup of coffee to start your morning with a splash of low-fat milk and a low-calorie sweetener.

Get Regular Exercise

Exercise is helpful for more than just weight loss — according to the Centers for Disease Control and Prevention (CDC), physical activity also helps to strengthen your muscles and bones, boosts your brain health, reduces your risk of heart disease and diabetes, and makes everyday tasks easier.9

In general, it’s recommended for adults to get 30 minutes of exercise 5 days a week, or 150 minutes total per week. This may seem like a lot, but it’s easier to think of it in small pieces rather than one large total. Try setting aside a designated time in your schedule for exercising — ask a family member or friend to tag along to help motivate you and keep you accountable.

You may think that exercising only means going to the gym, but the most important thing is finding activities you enjoy. This will make working out seem less like a chore and help you stick to it in the long run.

The CDC recommends a mix of aerobic and muscle-strengthening activities for the best results. Aerobic or “cardio” exercises raise your heart rate and make you sweat.10 Examples include:

  • Walking at a moderate pace, jogging, or running
  • Doing water aerobics or swimming laps
  • Riding a bike
  • Playing individual sports, such as tennis
  • Playing team sports, such as soccer or basketball

Muscle-strengthening activities work your major muscle groups, helping you build muscle mass. The more mass you have, the more calories your body burns to maintain it. Traditional strengthening activities use weights or resistance bands to perform different exercises designed to work a specific muscle group.

These exercises are most beneficial when you perform repetitions (reps) in a set. For example, you may want to do 8 to 12 reps of an exercise for 3 sets, taking a break between each set. As your muscles become stronger, you can add more weight or increase your reps.

Other examples of muscle-strengthening activities include:

  • Heavy gardening or housework
  • Certain forms of yoga, such as power yoga
  • Bodyweight exercises, such as sit-ups, pull-ups, or push-ups

Managing Other Health Conditions with NAFLD

Many people living with NAFLD also have other underlying health conditions that may be contributing. Your doctor will want to address these conditions to help treat NAFLD, possibly prevent it from progressing to NASH, or decrease risks of associated conditions.11 Your medical team may:12

  • Treat your high blood pressure
  • Treat your diabetes with insulin therapy, metformin, or other diabetes medications
  • Treat your high cholesterol with statins or other cholesterol-lowering medications
  • Recommend specific diet changes to help lower your blood sugar or cholesterol

Some patients may benefit from bariatric surgery, or from Vitamin E in high dose for NASH, but such treatments need to be individualized and discussed with your doctor.

The Future of NAFLD Treatments

Currently, there aren’t any treatments approved by the U.S. Food and Drug Administration (FDA) for treating NAFLD and NASH. However, as doctors and researchers continue to learn more about these diseases, they’re finding new ways to treat them. Before the FDA can approve these new treatments for NAFLD, they first need to go through clinical trials. These studies ensure that any new drug or medical procedure is safe and effective for the general public.