There are plenty of health conditions out there with obscure, hard-to-pronounce medical names. Then there’s fatty liver, an unsettling term that frightens many patients. Fatty liver includes a broad spectrum of conditions classified by an abnormal accumulation of certain fats (triglycerides) inside liver cells. It is indeed a serious condition and can have significant health consequences if it’s not properly addressed.

But with the right approach, it’s possible to control and even reverse the effects of fatty liver. That starts with understanding the condition, its causes, who’s at risk, and the steps people can take to reduce its potential impact. Here are four things patients should know about fatty liver.

Doctors don’t call it fatty liver anymore

All the concern over the term fatty liver will soon be a thing of the past. In 2023, the American Association for the Study of Liver Disease (AASLD) updated the nomenclature around steatotic liver disease and fatty liver. The changes include renaming and recategorizing different forms of steatotic liver disease.

Fatty liver due to any condition except consumption of large amounts of alcohol used to be called nonalcoholic fatty liver disease (NAFLD). Yet terms like “fatty” and the focus on alcohol can be stigmatizing and, in some cases, may prevent patients from seeking treatment. So, the AASLD updated the name. The overall category of fatty liver is now reclassified as steatotic liver disease (SLD), and metabolic-associated fatty liver (previously known as nonalcoholic fatty liver or NAFL) is now known as metabolic dysfunction-associated steatotic liver disease (MASLD). Other changes include renaming inflammation of the liver due to NAFLD from nonalcoholic steatohepatitis (formerly NASH) to metabolic dysfunction-associated steatohepatitis (MASH).

While some people may still use fatty liver and older terms in talking about the conditions, there’s a push to use more accurate and less stigmatizing language.

There are different causes of fatty liver

Fatty liver, now called steatotic liver disease, has many different causes. As the name update suggests, consumption of large amounts of alcohol is one common cause. This condition is called alcohol-associated (alcohol-related) liver disease.

On the other hand, MASLD includes at least one of the components of metabolic syndrome, such as excess body weight, high fat levels in the blood (triglyceride and cholesterol), and insulin resistance. The obesity epidemic in America is driving an increase in MASLD. Screening for the condition is recommended for some patients, including individuals with obesity, metabolic syndrome, type 2 diabetes, significant history of alcohol use, and a family history of fatty liver.

In some cases, a combination of metabolic factors and increased alcohol use can contribute to fatty liver. This condition is known today as “MASLD and increased alcohol intake” which is commonly referred to as “MetALD”. It’s important for patients to understand that even social drinking can have a negative effect, and it’s not just hard alcohol that can contribute to fatty liver. Beer and wine can have the same effects.

Fatty liver is often reversible

The good news is that with the right approach and lifestyle changes, patients can actually improve or completely resolve the effects of fatty liver conditions. That starts with maintaining a healthy weight with a healthy diet heavy on leafy green vegetables and light on sugar and processed foods. Regular exercise, limiting (or eliminating) alcohol use, and controlling things like blood pressure and cholesterol are also important. These steps can have a wide range of other health benefits, as well. It is important to get started on addressing fatty liver conditions because the inflammatory changes in metabolic dysfunction-associated steatohepatitis (MASH) can progress to cirrhosis which may not be reversible.

An honest conversation with your doctor is the best place to start

For individuals concerned about fatty liver, the best first step to take is to have an open conversation with your physician. Be honest about your lifestyle and drinking habits. Based on that conversation, the doctor will recommend any necessary lifestyle changes and potentially refer you to a gastrointestinal or hepatology (liver) specialist for a screening or other next steps. Doctors will likely tell you to avoid liver cleanses or other detoxes, which can have harmful side effects.

Ultimately, the power is in a patient’s hands to take proactive steps to reduce their risk of fatty liver or prevent the condition from getting worse. The best thing to do is to come prepared for a conversation with your doctor about the condition and how best to approach it.