Do you have questions about living with and reversing fatty liver disease?
In today’s post, I have the answers.
Let’s look at some of the hottest questions.
Does fatty liver disease have symptoms?
Symptoms are relatively rare with the most likely being fatigue which, of course, can be caused by a number of other things.
Can I reverse fatty liver disease?
Yes, you can.
Fatty liver disease, now known as MASLD, is a build-up of fat in your liver cells that can be quantified through imaging such as MRI or more commonly FibroScan.
To reverse fatty liver disease, you need to reduce the amount of fat in your liver below the 5% mark.
As I mentioned in the beginner’s guide to reversing fatty liver disease, this is possible through diet and lifestyle changes.
Maintaining lower liver fat levels will depend on maintaining a healthy lifestyle, so it’s not just a matter of changing your diet for a few months.
That being said, let’s talk timelines.
What is the best diet to reverse fatty liver disease?
A Mediterranean diet high in polyphenols, in my professional opinion.
I can help you bring it to life.
How long does it take to reverse fatty liver?
The answer to this depends on how severe the onset of your fatty liver disease is and more importantly how easily you are able to adopt the diet and lifestyle changes necessary to reduce the levels of fat in your liver.
For most people, getting a FibroScan is the most affordable way to measure liver fat levels.
In my practice, and also considering the best available data, you can see a significant reduction in liver fat (one point reduction in FibroScan scores) in just 3-6 months.
Liver fibrosis, which is more difficult to reverse, will take almost a full year to decrease by one degree and will likely require you to reduce your body weight by 10% as part of your diet + lifestyle changes.
Do I need to take supplements to reverse fatty liver?
I cover this topic in great detail in my post on the best supplements for fatty liver disease.
How much should I care about liver enzymes?
Liver enzymes are not always reliable indicators of fat levels in your liver.
They can fluctuate more and stay high even if liver fat levels drop – so don’t rely too much on them.
Try to focus on imaging through the FibroScan and/or look at key metabolic markers such as triglycerides, blood sugar, insulin and HDL – if these are going in the right direction, it’s very likely that your liver fat levels are dropping.
How much “fat” is in my liver?
The human liver weighs about 3-3.5 kg.
To be diagnosed with fatty liver disease, 5% or more of that weight must be stored fat – that is NOT a huge amount of fat.
In reality, it’s a very small amount that slowly adds up due to insulin resistance, physical inactivity, and a less-than-balanced diet that accumulates negative effects on your body over time.
This small amount, however, can lead to inflammation and damage to your liver if you don’t do anything about it.
What is the best type of physical activity for fatty liver?
Both resistance training and aerobic training have been shown to have positive effects on reducing liver fat levels – in a perfect world it’s best to do both.
But if the ultimate primary short-term goal is to reduce liver fat, cardiovascular activity seems to take precedence based on all of the current evidence.
Both are important, end of the day.
Will I end up with cirrhosis?
After a fatty liver diagnosis, all the cards are in your hands.
Only a very small % of people (<5%) will progress from an early diagnosis of fatty liver disease to cirrhosis over a 20-year period.
If you make diet and lifestyle changes today, it is EXTREMELY unlikely that fatty liver disease will progress.
In fact, it is much more likely that it will subside and you can reverse it.
That’s where I come in, reach out if you’re ready to work together to fight fatty liver disease.
What about alcohol?
The majority of people who end up with fatty liver don’t get there because of excessive alcohol consumption.
That said, you should aim to drink as little alcohol as possible (none is better) for both your liver and overall health.
What about lean fatty liver?
About 10% of people diagnosed with fatty liver have a BMI in the “normal” range.
Genetic factors, diet and lifestyle are very important for liver health, regardless of your body weight.
What about GLP-1 drugs?
You can reverse fatty liver disease without losing significant weight, but it’s also true that losing weight (at least 5%) can reduce levels of fat in the liver.
Health Canada recently approved Wegovy for advanced fatty liver disease (MASH) because it seems that losing 10% of a person’s body weight for this form of fatty liver helps a lot.
You do NOT need to use GLP-1 drugs to reverse fatty liver disease, but for the right person who is unable to make diet/lifestyle changes it could theoretically help.
Is fatty liver a VERY bad sign?
No, it’s just a bad sign.
The reason I went into fatty liver is because ALL the cards are still in your hand.
Yes, your body is telling you (by storing fat in the liver) that some systems are not working as they should and that you should probably take nutrition more seriously.
It’s not all doom and gloom, you got it.
What else should I know?
Your liver and gut are connected, foods that feed your healthy gut bacteria are VERY likely also very good for your liver.
You can find out what these are in my post on this topic linked here.
Can you help me reverse fatty liver disease?
YES, I can.
Contact me through my contact form.
Andy De Santis RD MPH
