Fatty liver – Symptoms, causes, types and other risk factors

Fatty liver

Fatty liver is also known as hepatic steatosis. This is a term which describes the buildup of fat in the liver. It is normal to have some fat in the liver but when we have too much fat in the liver, and then it can become a serious health problem. The second largest organ in our bodies is the liver. The function of the liver is to process everything we drink or eat and filter any harmful substances from our blood. This process is interrupted if there are too many fats in the liver.  You have fatty liver, then fat accounts for more than five to ten percent of your liver’s weight. We know that the liver commonly repairs itself by rebuilding new liver cells when the old ones are damaged. When we have repeated damage of our liver, then permanent scarring is taking place. This condition is known as cirrhosis. [1] This is a reversible condition which in many cases can be resolved with the usage of lifestyle modifications. There are many cases when fatty liver has not symptoms. This condition usually does not cause permanent damage unless it progresses. This is one of the most common conditions around the world and it is affecting 10 – 20% of Americans without inflammation or cirrhosis. [2]

Symptoms of fatty liver

This condition usually does not have associated symptoms. You can experience vague abdominal discomfort or fatigue. Also your liver can become slightly enlarged and your doctor this can see through a physical exam. But the excess fat in your liver can cause inflammation. If your liver becomes inflamed, then you can have symptoms such as:

  • Confusion
  • Fatigue
  • Physical weakness
  • Abdominal pain
  • Weight loss
  • A poor appetite

If the fatty liver progresses to liver failure and cirrhosis, then the symptoms can include:

  • A tendency to bleed more easily
  • Confusion
  • Jaundice on the skin and yellowing of the eyes
  • An enlarging, fluid – filled abdomen

Causes for fatty liver

Causes for fatty liver

Alcoholism and heavy drinking are the most common causes for fatty liver. [3] There are many cases when doctors do not know which the reason for this in people who do not drink too much alcohol. When our bodies create too much fat or when it cannot metabolize fat fast enough, then this condition is developing. The excess fat which is stored in the liver cells where it accumulates, it is forming the fatty liver disease. When you eat a high – fat and high – sugar diet, they may not directly result in fatty liver but they can contribute to this condition. Also there are many other common conditions which can lead to fatty liver such as

  • Side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex) and tetracycline (Panmycin)
  • Rapid weight loss [4]
  • Genetic inheritance
  • Diabetes [5]
  • Hyperlipidemia or high levels of fats in the blood [6]
  • Obesity [7]

Risk factors: Fatty liver is the buildup of extra fats in the liver. If you are obese or overweight, then you have increased chances of developing it. Also when you have diabetes type 2, then you have increased risk of developing this condition. [5] Fat accumulation in the liver is also linked to insulin resistance which is the most common cause for the diabetes type 2. There are some studies in which is shown that a high – choline diet is linked to a lower risk of this disease. [8] Also there are other factors which can increase your risk of fatty liver such as:

  • Metabolic syndrome
  • Malnutrition
  • High triglyceride levels
  • High cholesterol
  • Pregnancy [9]
  • Taking more than recommended doses of certain over – the – counter medications such as acetaminophen (Tylenol)
  • Excessive alcohol use [3]

Types of fatty liver:

  1. Nonalcoholic fatty liver disease: It develops when the liver has difficulty breaking down fats which causes a buildup in the liver tissue. This cause is not related to alcohol.
  2. Alcoholic fatty liver: This is the earliest stage of alcohol – related liver disease. Heavy drinking can damage your liver and the liver cannot break down fats as a result. When you are abstaining from the alcohol will likely cause the fatty liver to subside. In a period of six weeks of not drinking alcohol, the fat will disappear. But if the excessive alcohol use continues, then the cirrhosis can develop.

Most cases of fatty liver are defected in people who are between ages 40 – 60. If the underlying cause for fatty liver is not recognized and treated, then that can become harmful to your liver. [10]


[1] Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371(9615):838–51.

[2] Jarvis LM. Facing a silent liver disease epidemic. Scientific American. 2016. Retrieved from www.scientificamerican.com

[3] Osna NA, Donohue TM, Kharbanda KK. Alcoholic liver disease: Pathogenesis and current management. Alcohol Research. 2017;38(2):147–61.

[4] Gill HK, Wu GY. Non-alcoholic fatty liver disease and the metabolic syndrome: Effects of weight loss and a review of popular diets. Are low carbohydrate diets the answer? World Journal of Gastroenterology. 2006;12(3):345–53.

[5] Loria P, Lonardo A, Anania F. Liver and diabetes. A vicious circle. Hepatology Research. 2013;43(1):51–64.

[6] Al-Jameil N, Khan FA, Arjumand S, et al. Associated liver enzymes with hyperlipidemic profile in type 2 diabetes patients. International Journal of Clinical and Experimental Pathology. 2014;7(7):4345–9.

[7] Schiavo L, Busetto L, Cesaretti M, et al. Nutritional issues in patients with obesity and cirrhosis. World Journal of Gastroenterology. 2018;24(30):3330–46.

[8] Corbin KD, Zeisel SH. Choline metabolism provides novel insights into non-alcoholic fatty liver disease and its progression. Current Opinion in Gastroenterology. 2012;28(2):159–65.

[9] Mikolasevic I, Filipec-Kanizaj T, Jakopcic I, et al. Liver disease during pregnancy: A challenging clinical issue. Medical Science Monitor. 2018;24:4080–90.

[10] Frith J, Jones D, Newton JL. Chronic liver disease in an ageing population. Age and Ageing. 2009;38(1):11-8.



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