What's the Link Between Obesity & Fatty Liver Disease?


Obesity can lead to or exacerbate a number of other chronic diseases, such as heart disease, type 2 diabetes, and obstructive sleep apnea. Fatty liver disease is another serious disease that is associated with obesity.

What Is Fatty Liver Disease?

Fatty liver disease, also referred to as nonalcoholic fatty liver disease (NAFLD), is a form of liver disease in which fat accumulates in the liver. As the full medical name suggests, while this buildup of fat in the liver can be caused by drinking too much alcohol, NAFLD specifically refers to the form of the disease that is found in those who drink little or no alcohol.

In some people, the fat that builds up in the liver causes inflammation and scarring, and can even lead to cirrhosis. This scarring can become so severe over time that the liver no longer functions adequately, leading to a diagnosis of liver failure.

What Causes Fatty Liver Disease?

It is not yet clear what causes the nonalcoholic form of fatty liver disease, but several associations have been made. For instance, it has been observed that most of the people who develop nonalcoholic fatty liver disease are obese and/or have type 2 diabetes or insulin resistance.

According to the Canadian Liver Foundation, it is estimated that 75 percent of individuals who are obese are at risk of developing fatty liver, and up to 23 percent of obese individuals are at risk of developing fatty liver with inflammation.

Other conditions that have been associated with fatty liver disease include nutritional causes such as, paradoxically, starvation and protein malnutrition and rapid weight loss.

Thus, if care is not taken, fatty liver disease can also be caused by gastric bypass surgery for the treatment of obesity.

How Is it Diagnosed?

A diagnosis of fatty liver disease is often first suspected when a patient with risk factors is found to have abnormal (elevated) liver tests or an enlarged liver.

An ultrasound of the liver can often suggest the presence of fatty liver disease. Other diagnostic tests include CT scan and MRI. In some cases, a liver biopsy is recommended.

What Is the Treatment?

Currently, there are no medications that are proven to treat fatty liver disease effectively. Treatment is aimed at lifestyle changes, including weight loss and physical activity in order to reduce the amount of fat in the liver. As noted above, it is important that weight loss be gradual and achieved in a healthy fashion, or else one risks worsening the excess storing of fat in the liver.

Studies have found that losing 5 to 10 percent of excess weight is necessary to reduce the amount of fat in the liver, and above 10 percet is needed to improve the inflammation in those who have that form of the disease.


Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol. 2013;10(6):330-44. doi:10.1038/nrgastro.2013.41.

Fatty Liver Disease. Canadian Liver Foundation Public Information Sheet. http://www.liver.ca/liver-disease/types/fatty-liver.aspx

Non-alcoholic Fatty Liver Disease (NAFLD). American Liver Foundation Public Information Sheet.

Nonalcoholic Steatohepatitis. US Department of Health and Human Services Public Information Sheet. 

Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA. 2015;313:2263-2273.

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