It’s happening with alarming frequency: Someone has routine blood work done and an increase in liver markers, AST, ALT, and sometimes GGT, are noted. The doctor sometimes then orders a liver ultrasound, CT, or MRI and infiltration of the liver with fat is identified, the situation called fatty liver. If caught in later stages, fibrous tissue can be seen replacing normal liver tissue, meaning that someone is progressing to cirrhosis, a very bad condition. 

Add fatty liver to the widespread epidemics of overweight, obesity, and type 2 diabetes. People with these conditions are also the ones who typically also have fatty liver. In other words, fatty liver is, in the majority of cases just another facet of obesity and type 2 diabetes. The risk is that fat infiltration of the liver can progress to more serious liver diseases such as cirrhosis and liver cancer. Fatty liver is a situation that applies to about 30-50% of the U.S. population, even higher in some groups of people. 90% of people undergoing bariatric procedures to lose weight, for example, have fatty liver.  

Most doctors will then tell you that there is nothing you can do about this situation. Perhaps lose a few pounds, that might help. But he/she tells you that they will monitor liver tests as you progress to cirrhosis and liver failure, then prepare you for a liver transplant. These is awful advice. Cirrhosis is a very serious and often fatal condition with extremely messy complications such as esophageal varices, i.e., varicose veins in the esophagus that rupture, causing profound hemorrhage. It causes jaundice and accumulation of ascites, or fluid in the abdomen, causing grotesque enlargment of the abdomen. And liver transplant is a terrible procedure that only adds a few years to your life if it is successful.

 The truth, however, is that most people can reverse fatty liver on their own within a few weeks without drugs, without procedures, without surgery. So let’s talk about that. 

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