Nonalcoholic Fatty Liver Disease Treatment Options

Traditionally, management strategies for this type of liver disease have focused on weight loss. But it’s important to work closely with your doctor because new treatments are emerging.

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Non-alcohol-related fatty liver disease (NAFLD) is a disease in which fat builds up in your liver. It often does not cause any symptoms in the early stages, so many people who have it don’t even know that they do. However, NAFLD affects 24% of adults in the United States.

There are two main subtypes of NAFLD, which may also be called metabolic dysfunction-associated steatotic liver disease (MASLD).

Most people have the type that’s known as nonalcoholic fatty liver (NAFL), which leads to fatty buildup but doesn’t damage the liver. NAFL may also be called steatotic liver disease.

Over time, the condition can progress to a more serious type known as nonalcoholic steatohepatitis (NASH). NASH may also be called metabolic dysfunction-associated steatohepatitis (MASH).

With NASH, inflammation in your liver can eventually cause scarring (fibrosis), which can lead to permanent liver damage (cirrhosis).

Traditionally, NAFLD treatment has centered on weight loss strategies. However, new treatment options are starting to emerge.

Here’s what you need to know about treatment possibilities if you have NAFLD or are at risk of developing it.

Understanding treatment recommendations for NAFLD

If you have obesity or overweight, you could be at an increased risk of developing NAFLD.

Obesity is one of the biggest risk factors for NAFLD, along with type 2 diabetes, insulin resistance, high LDL (“bad”) cholesterol or high triglycerides, and high blood pressure.

As a result, doctors typically recommend weight loss for people who have NAFLD. Losing 3% to 5% of your body weight can reduce the amount of fat in your liver. Losing even more — 7% to 10% of your body weight — can reduce inflammation and scarring in your liver.

Your doctor may recommend a combination of strategies to help you lose weight, such as:

  • changing your diet
  • reducing portion sizes
  • exercising regularly
  • reducing or avoiding alcohol consumption

In some cases, doctors may recommend weight loss medications or even surgery. These strategies can help lower your risk of developing NAFLD or help treat it if you’ve already received a diagnosis.

If you have high cholesterol or high blood pressure, your doctor may also recommend medications to get those numbers into the recommended ranges. And if you have diabetes, your doctor may encourage you to take steps to better manage your blood sugar levels.

Research also suggests that vitamin E, either on its own or in combination with hydroxytyrosol, can be helpful for reducing fatty buildup (steatosis) and scarring in the liver. However, as with any supplement, you should talk with your doctor before taking it on your own.

A new advancement in treatment

If your NAFLD progresses to the more serious NASH, you may be a candidate for a new medication that’s available for people who have developed moderate to severe liver scarring from NASH.

In March 2024, the Food and Drug Administration (FDA) approved the use of an oral medication called resmetirom (Rezdiffra) for people with NASH. Resmetirom is a thyroid hormone receptor beta agonist. It helps reduce the amount of fat that builds up in the liver and causes inflammation.

Research suggests that taking resmetirom can help decrease inflammation and scarring in the liver. Common side effects include diarrhea and nausea. More serious complications can affect your liver and gallbladder.

Regardless of whether you’re a candidate for resmetirom, your doctor will talk with you about your options and the best ways to protect your liver. They may also check your liver function regularly and look for signs of progression.

Focusing on your health over the long term

If you have NAFLD, you can take other steps to keep yourself (and your liver) as healthy as possible.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends staying active, eating a nutritious diet, and taking steps to lose weight (if you have overweight or obesity).

Your doctor may also recommend that you avoid anything that could pose any potential harm to your liver, including certain prescription and over-the-counter drugs and alcoholic drinks.

The NIDDK also suggests that you avoid using any dietary supplements, herbal remedies, or other complementary medicines without consulting your doctor first.

It’s important to work closely with your doctor while managing NAFLD. Even if you’re not a candidate for the currently available treatment, researchers may develop new medications in the future that may help preserve liver health.

Editorial note:

  • NASH may also be called metabolic dysfunction-associated steatohepatitis (MASH).
  • NAFLD may also be called metabolic dysfunction-associated steatotic liver disease (MASLD).
  • Fatty liver disease may also be called steatotic liver disease.

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