Fatty Liver: What Is It? Do You Have It? How Is It Treated?

Fatty Liver: What Is It? Do You Have It? How Is It Treated?

Medically reviewed by Dr. George Kosco, DO on February 14, 2020

Definition | Video | How It Develops | Tests & Risk Factors | Treatment Options

Fatty liver is a common disease. It is strongly influenced by a poor diet that is high in refined carbs and fructose. These troublesome nutrients are found in fast food meals, soda, and the 3C’s (cookies, cakes, and candies). 

In this article, I’ll explain how to tell if you have a fatty liver and how, if caught early, it is treated.

Fatty Liver At-A-Glance

  • Your liver is your detox organ and important for an efficiently running metabolism
  • If not caught early, fatty liver can progress to NASH, which can lead to scarring or cirrhosis of the liver
  • A high intake of sugar and fructose causes fat to accumulate in the liver. 
  • Fatty liver is detected using a scan (i.e. ultrasound or a CAT scan) and associated with elevated liver enzymes, which can be detected in the blood. 
  • In its early stages, fatty liver can be treated with diet, exercise, and supplements

What Is Fatty Liver? 

Fatty liver or more correctly nonalcoholic fatty liver disease is just what you’d imagine from its name. It is the accumulation of fat in your liver that is not caused by drinking alcohol. It is considered the most common liver disease in western societies (1).

Fatty liver is closely linked to insulin resistance, which is a common barrier to weight loss. Most people have no idea that they have it. 

If you carry a lot of belly fat, you have trouble losing weight, and you are a regular soda drinker or eat a lot of sugar and refined carbs, there is a good chance that you have some degree of this metabolic issue.

fatty liver disease definition

Fatty Liver: What Is It? Do You Have It? How Is It Treated? [Video]

In this video, you’ll learn…

  • An answer to the question: what is a fatty liver?
  • How fatty liver develops and which foods/drinks contribute to it.
  • How to treat fatty liver with exercise and diet.

The Importance of Your Liver

The liver is very important for an efficiently running metabolism, but we also think of it as the detoxifying organ. 

When something is inflammatory or potentially damaging to your body, your liver is the organ that filters and removes those harmful compounds. 

When we feed our bodies processed foods full of unnatural chemicals, we create an inflammatory state in the body. It is the liver that takes the brunt of that abuse. 

Fatty Liver in Children

You cannot outrun the metabolic effects of a poor diet.

Developing a fatty liver is certainly one of those hidden metabolic effects that is caused by a poor diet.

Unfortunately, it is even showing up in children. According to Boston Children’s Hospital website, it affects approximately 10% of our kids.

Fatty Liver Progression to NASH

If it is not caught early, it silently progresses in both kids and adults into an inflammatory state called NASH or Non-alcoholic steatohepatitis.

NASH can cause scarring or cirrhosis of the liver. At that point, the condition is no longer reversible. According to Dr. Julie Heimbach, who is a liver transplant surgeon at Mayo Clinic, it is one of the most quickly rising indications for liver transplant in the United States.

In other words, fatty liver is a problem that is caused by eating or drinking the wrong things. If caught early enough, it is a condition that is treated by consuming the right things. 

How Fatty Liver Develops

A fatty liver develops when your liver takes nutrients from your diet and makes fat through a process called de novo lipogenesis. 

  • De novo means “from new”
  • Lipo means “fat”
  • Genesis means “beginning or making.”

De novo lipogenesis is literally the making of fat from new things. In other words, things other than the fat we eat. That’s the surprising part, right?  

Logic tells us that eating too much fat would cause the liver to store excess fat. Instead, what we see is that lipogenesis is driven by sugar and more importantly fructose in your diet. 

This could explain why the disease is so common in children because one of the main sources of fructose in the Standard American Diet is high fructose corn syrup, which is found in regular soda. 

Kids and adults who drink a lot of soda, have a high risk for developing fatty liver (2).

Foods & Drinks That Contribute to Fatty Liver

Soda is not the only culprit. Refined carbs and sugar which I refer to as our 3 C’s: cookies, cakes, and candies, are also to blame.

Sharing the blame are starchy carbs like pasta, bread, bagels, and muffins. All of these foods break down into sugar in your bodies and feed the fat making factory in your liver. 

The effects of a high-carb diet do not take long to show up. In a study, overweight individuals who were fed a high-calorie, high-sugar diet for three weeks had a 27% increase in liver fat (3).

foods and drinks that contribute to fatty liver

The Vicious Loop of Fatty Liver

Even being overweight contributes to fatty liver. We get a vicious loop that develops.

We see inflammation increase in the body, which contributes to insulin resistance and the likelihood that fat will get deposited in your belly. This, added abdominal girth, creates more inflammation and more damage (4).

Tests and Risk Factors for Fatty Liver

How do you know if you have a fatty liver? The challenge is that symptoms are not easy to detect and the damage is often done before the disorder is discovered.

If you’re concerned that you have a fatty liver, there are some tests that your doctor can run to provide a diagnosis.

  • Fatty liver is associated with elevated liver enzymes that can be detected in the blood.
  • Evidence of a fatty liver can be detected using a scan, such as an ultrasound or a CAT scan. 

Risk factors include

  • Carrying a lot of belly fat
  • Eating a lot of sugar and refined carbs
  • Drinking a lot of soda or sweetened drinks

Treatment Options

What do you do about it? We learned that a poor diet contributes to the disorder. Fortunately, making corrections to your diet can reverse the progression, at least in its early stages.

Let’s go over some diet, exercise, and supplement solutions that can help.


As for diet, you’ll start strong if you cut out soda and drinks sweetened with high-fructose corn syrup or sugar. High consumption of these drinks is one of the quickest paths to a fatty liver. 

A healthy choice instead is green tea or tea made with milk thistle, which has been shown to be beneficial choices for liver health (5).

milk thistle for liver health

You can also cut out refined carbs and eat a low-carb diet. Carbohydrates are a non-essential nutrient meaning your body can make the building blocks of carbs if they are not coming in through your diet.

If you’re facing a diagnosis of a fatty liver, you’ll do best to look at non-starchy vegetables as your dietary carbohydrate source because they have the best nutrient to calorie ratio. 

In fact, getting those non-starchy vegetables into your diet is what I teach you how to do in my free 0123 strategy, which is a great way to jumpstart your healthy weight loss plan.

When you cut out refined and starchy carbs, like pasta, bread, and bagels don’t be afraid to replace those carbs with high-quality fatty foods and oils, which are great for hunger control.

Eat high-quality fatty foods like avocados

This low-carb/high-fat diet will improve your insulin sensitivity and help you lose weight, particularly belly fat, which is the dangerous fat that keeps you locked in the vicious cycle I spoke about earlier. 


You can also exercise to improve insulin sensitivity and all forms whether low intensity like walking when done regularly or higher intensity like sprinting intervals or weightlifting have been shown to be beneficial.


There are also spices and supplements that you can add including turmeric, which is a spice that you can use when cooking and omega-3 fish oils from either fatty fish or capsules.

Apple cider vinegar is also something to consider. In my blog post on apple cider vinegar, I discuss the research showing that apple cider vinegar improves blood sugar control and insulin sensitivity. Apple cider vinegar is something to look into if you’re looking for an inexpensive and easily available option. 

One last supplement that is definitely worth mentioning is berberine. This supplement can help to lower blood sugar and improve fatty liver disease. 


In a study, 184 participants with non-alcoholic fatty liver disease were split into three groups. Each group received diet and exercise interventions.

  • The first group received only diet/exercise interventions.
  • The second group received the interventions and a prescription medication.
  • The third group received the interventions and the supplement, berberine.

The participants taking the berberine supplement out-performed the other groups and had a significant reduction in liver fat and the most weight loss (6).

Of course, as I always say, supplements are called supplements for a reason. They are intended to supplement a healthy diet. They are not magic pills. You will be happiest with your results if you get your diet on track first. A low-carb diet is a good direction to explore. 


(1) Ahmed, Monjur. “Non-alcoholic fatty liver disease in 2015.” World journal of hepatology 7.11 (2015): 1450.

(2) Nseir, William, Fares Nassar, and Nimer Assy. “Soft drinks consumption and nonalcoholic fatty liver disease.” World journal of gastroenterology: WJG 16.21 (2010): 2579.

(3) Sevastianova, Ksenia, et al. “Effect of short-term carbohydrate overfeeding and long-term weight loss on liver fat in overweight humans.” The American journal of clinical nutrition 96.4 (2012): 727-734.

(4) Gaggini, Melania, et al. “Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease.” Nutrients 5.5 (2013): 1544-1560.

(5) Abenavoli, Ludovico, et al. “Milk thistle for treatment of nonalcoholic fatty liver disease.” Hepatitis Monthly 11.3 (2011).

(6) Yan, Hong-Mei, et al. “Efficacy of berberine in patients with non-alcoholic fatty liver disease.” PloS one 10.8 (2015): e0134172.

About the Author: 

Becky Gillaspy, DC graduated Summa Cum Laude with research honors from Palmer College of Chiropractic in 1991.

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