The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) is increasing across the world in line with the increase in obesity. While much of the focus of obesity education is on Type 2 Diabetes, cardiovascular disease and hypertension, the relationship between obesity and liver disease are less well understood. NAFLD affects up to 70% of obese patients.
On this page, we provide more information on liver disease and, importantly, the very significant benefits that weight loss plays in its treatment.
A weight loss of 7-10% of body weight is sufficient to achieve a 75% remission rate among NAFLD patients(1). At this level of weight, there are also studies that report a reduction in fibrosis.
All of the recognised weight loss surgery procedures, therefore, present a safe and effective form of treatment for those with early-stage liver disease (NAFLD/NASH).
What is Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-alcoholic fatty liver disease (NAFLD) is now the commonest cause of abnormal liver function tests (LFTs) in the UK with about one-third of the population affected. The exact prevalence is unknown, but studies from China and the US estimate that approximately 30% of the general population have steatosis (infiltration of liver cells with fat). It is a spectrum of disease ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. Most who are diagnosed with NAFLD have simple steatosis, but approximately 10–30% develop NASH. Those who go on to develop NASH cirrhosis generally have a poor long-term prognosis. Patients with NASH have increased liver-related and cardiovascular mortality. A large proportion of patients with NAFLD go undiagnosed, and recognising those at risk is the first step.
We address NAFLD here at Healthier Weight because obesity is a major risk factor, and because weight loss, even as little as 5% of a starting weight, can help achieve high rates of remission. Weight loss surgery and non-surgical weight loss procedures are a safe and effective treatment of early-stage liver disease in the obese population (BMI above 30).
How is Non-Alcoholic Fatty Liver Disease (NAFLD) Diagnosed?
There are several factors your GP will take into account when diagnosing non-alcoholic liver disease. These will include an assessment of risk factors including alcohol consumption, obesity, type 2 diabetes, hypertension and others. An initial diagnosis would be confirmed by a number of tests that are available through your GP clinic, including routine blood tests and more specialised blood tests. Ultrasound and biopsies may also be used to make a diagnosis.
How is Non-Alcoholic Fatty Liver Disease (NAFLD) Treated?
It’s important to remember that most people with NAFLD will not develop any serious problems. If you are diagnosed however it’s a good idea to take steps to stop it from getting any worse. Although there’s currently no specific medicine for the treatment NAFLD, making healthy lifestyle choices helps.
Some patients with NAFLD will be treated for related conditions, e.g. high blood pressure, diabetes, etc, and they may be advised to have regular appointments with a doctor to check liver function and to look for signs of new problems.
Adopting a healthy lifestyle is the main way of managing NAFLD, and the first priority is usually to lose weight and achieve a healthy weight. Studies show that a weight loss of more than 5% of starting weight results in remission for over 50% of patients. Furthermore, weight loss of more than 10% can remove some fat from the liver and improve NASH for those who have it.
Other recommendations are to eat a healthy diet, exercise regularly and not to smoke. Although NAFLD is not caused by alcohol, drinking can make it worse. It’s therefore advisable to cut down or stop drinking alcohol.
- An overview of dietary interventions and strategies to optimise the management of NAFLD. Diseases. 2017. Oct 22. 5(4)
- Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging – Jessica K Dyson et al. BMJ Journals
- NHS Guidance on diagnosis and treatment of NAFLD (January 2019)