Do you have questions about living with and reversing fatty liver disease?

In today’s post, I have the answers.

Let’s go through some of the hottest questions.

Does Fatty Liver Disease Have Any 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 an accumulation of fat in your liver cells that can be quantified via imaging like MRI or more commonly FibroScan.

In order to reverse fatty liver disease, you have to reduce the amount of fat in your liver below the 5% threshold.

As I discussed in my beginner’s guide for reversing fatty liver disease, this is achievable via nutrition and lifestyle changes.

Maintaining lower liver fat levels will depend on keeping up with 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 For Reversing Fatty Liver Disease?

A high polyphenol Mediterranean diet, 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 your fatty liver disease is to start and even more importantly how readily you are able to adopt the dietary and lifestyle changes necessary to reduce your liver fat levels.

For most people, getting a FibroScan is the most accessible 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 ( going down a grade in FibroScan scores) in as little as 3-6 months.

Liver fibrosis, which is more challenging to reverse, will take closer to a full year to reduce by one grade and will likely require you to reduce your bodyweight by 10% as part of your diet + lifestyle changes.

Do I Need To Take Supplements To Reverse Fatty Liver?

I cover that 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 your liver fat levels.

They can fluctuate more and remain high even if liver fat levels are going down – so don’t rely on them too much.

Try to focus on imaging via FibroScan and/or look at key metabolic markers like triglycerides, blood sugar, insulin and HDL – if these are going in the right direction it is very likely that your liver fat levels are dropping.

How Much “Fat” Is In My Liver?

The human liver weighs around 3-3.5 pounds.

To be diagnosed with fatty liver disease, 5% or more of that weight has to be stored fat – this is NOT a huge amount of fat.

In fact, it is quite a small amount that slowly adds up due to insulin resistance, physical inactivity and a less than balanced diet accumulating a negative effect on your body over time.

This small amount, however, can lead to inflammation and damage in your liver if you do nothing about it.

What Is The Best Type Of Physical Activity For Fatty Liver?

Both resistance training and aerobic training have demonstrated positive influences on reducing liver fat levels – in a perfect world doing both is best.

If the absolute main short-term goal is reducing liver fat though, cardiovascular activity seems to have the edge based on the totality of current evidence.

Both are important, end of 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 go from an early fatty liver disease diagnosis to cirrhosis over a 20 year period.

If you make diet and lifestyle changes today, it is HIGHLY unlikely your fatty liver disease will progress.

In fact, it is much more likely that it will regress and that you will reverse it.

That’s where I come in, reach out if you are ready to work together to fight back against fatty liver disease.

What About Alcohol?

The majority of people who end up with a fatty liver do not get there due to excessive alcohol consumption.

That being said, you should aim to drink as little alcohol (none is best) as possible for both your liver and general health.

What About Lean Fatty Liver?

About 10% of people with a fatty liver diagnosis have a BMI in the “normal category”.

Genetic, diet and lifestyle factors are very relevant for your liver health independent of your bodyweight.

What About GLP-1 Medications?

You can reverse fatty liver disease without losing a significant amount of weight, but it is also true that weight loss ( of at least 5%) can reduce liver fat levels.

Health Canada recently approved Wegovy for advanced fatty liver disease ( MASH) because it does seem losing 10% of one’s bodyweight for this form of fatty liver helps a lot.

You do NOT need to use GLP-1 medications to reverse fatty liver disease, but for the right person who is not in a position to make diet/lifestyle changes they could theoretically help.

Is Fatty Liver A VERY Bad Sign?

No, it is just a bad sign.

The reason why I got into working in fatty liver is because ALL the cards are in your hands still.

Yes, your body is telling you (by storing liver fat) that some systems are not working as well as they should and that you probably need to take nutrition more seriously.

It’s not all doom and gloom, you got this.

What Else Should I Know?

Your liver and gut are connected, the foods that feed your healthy gut bacteria are VERY likely also very good for your liver.

You can learn what those are in my post on that topic linked here.

Can You Help Me Reverse Fatty Liver Disease?

YES, I can.

Reach out to me via my contact form.

Andy De Santis RD MPH