Liver Diseases / Fatty Liver Disease

Fatty Liver Disease

Fatty liver disease is characterized by the buildup of extra fat in liver cells that is not caused by alcohol consumption.

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what is fatty liver disease?

Fatty liver disease is defined as the buildup of extra fat in liver cells, that is not caused by alcohol consumption. It is normal for the liver to contain some fat, however, if more than 5% of your liver’s weight is fat, that’s when you’re likely to be diagnosed with fatty liver disease.

There are two main medical terms for fatty liver disease: metabolic dysfunction–associated steatotic liver disease, or MASLD for short, and metabolic dysfunction-associated steatohepatitis, or MASH for short. MASH is the more advanced form of fatty liver disease, which causes the liver to swell and become damaged.

*MASLD was formerly known as Non-alcoholic fatty liver disease and MASH was formerly known as Non-alcoholic steatohepatitis.

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What is MASLD?

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What is MASH?

fast facts

  • MASLD is the most common form of liver disease in Canada, affecting at least 25% of all adults.
  • Approximately 8 million Canadians are affected by MASLD.
  • 25% of those living with MASLD develop MASH, which can further progress to severe scarring of the liver (cirrhosis).
  • If detected early, fatty liver disease can be improved, or even reversed, with lifestyle and nutrition modifications.

symptoms

In its early stages, MASLD often has no noticeable symptoms. But as the disease progresses, signs may begin to appear. These symptoms include: 

  • Unexplained weight loss
  • Pain in the upper right abdomen
  • Fatigue and weakness
  • Yellowing of the eyes and skin (jaundice)
  • Shortness of breath
  • Swelling in the legs, ankles, feet, and/or abdomen
  • Mental confusion (hepatic encephalopathy)
  • Loss of appetite
  • Itchy skin

what does this mean?

You many be wondering, “how does fat get into my liver?” Fat and sugars from a person’s diet are usually broken down by the liver and other tissues. If the amount of fat or sugar intake exceeds what is required by the body, fat is stored in the fatty tissue. Other reasons for the accumulation of fat in the liver could be the transfer of fat from other parts of the body, or the inability of the liver to convert it into matter that can be eliminated by the body.

Fatty liver disease is more common in individuals who are overweight or obese, but it can also occur in adults with healthy body weights.

Besides obesity, nutritional causes of fatty liver disease are:

  • Starvation and protein malnutrition
  • Long-term use of total parenteral nutrition (a feeding procedure that involves infusing nutrients directly into the bloodstream)
  • Intestinal bypass surgery for obesity
  • Rapid weight loss

Certain conditions often accompany and may contribute to fatty liver disease:

  • Diabetes mellitus
  • Hyperlipidemia (elevated lipids in the blood)
  • Insulin resistance and high blood pressure

Other causes include:

  • Genetic factors
  • Drugs and chemicals

lifestyle impacts

Overcoming a fatty liver disease diagnosis often requires lifestyle modifications like healthy eating, regular physical activity, and avoiding alcohol. The early stages of fatty liver disease can be reversed with lifestyle changes.

If you have fatty liver disease, symptoms like fatigue and weakness can make performing daily, essential tasks difficult.

what can i do?

prevention

You can prevent fatty liver disease by doing the following:

  • Maintain a healthy weight
  • Eat a balanced diet
  • Perform daily physical activity
  • Limit your alcohol consumption
  • Follow medication dosage recommendations

diagnosis

Fatty liver disease is often diagnosed through the following methods:

  • Blood tests (liver function tests): Elevated liver enzymes can be an early sign of liver inflammation or damage.
  • Imaging tests: Ultrasound, MRI, CT scan, or FibroScan can help detect fat in the liver and assess liver stiffness.
  • Liver biopsy: If more clarity is needed, a small sample of liver tissue may be taken to check for inflammation or scarring. This is the most accurate way to diagnose advanced liver disease or MASH.

treatment

There is currently no cure for fatty liver disease. Lifestyle modifications are often the first thing that’s recommended to reduce the fat in your liver. The treatment of other metabolic conditions – that are often associated with fatty liver disease – may also occur.

How to implement lifestyle changes

Lifestyle changes look different for everyone, the key is finding what fits your life. Here are a few tips to get started:

  • Choose what you enjoy: You’re more likely to stick with exercise and nutrition habits you genuinely like.
  • Set SMART goals: Make your goals Specific, Measurable, Achievable, Relevant, and Time-bound to stay on track.
  • Lean on your support system: Surround yourself with people who encourage and support you on your journey.

Be patient with yourself. Focus on progress, not perfection. Make small changes one step at a time.

additional resources

Here are a few questions to ask your doctor or medical team:

  • What stage of fatty liver disease do I have?
  • Do I have any signs of liver inflammation or fibrosis?
  • Is it possible that I have progressed to MASH?
  • Should I have additional testing, like a Fibroscan, MRI, or liver biopsy?
  • What likely caused my MASLD?
  • Do I have, or am I at risk of other metabolic conditions, like insulin resistance or diabetes?
  • How does MASLD impact my heart health?
  • Are there any medications or supplements that I should avoid?
  • Are there any medications I can take or clinical trials I can participate in to treat MASLD?
  • How often should I have liver function tests or imaging done to monitor my condition?
  • What signs or symptoms should I watch for that might mean my condition is worsening?

Liver Canada Resources