From the Guidelines
The primary treatment for Steatosis (Fatty Liver Disease) involves lifestyle modifications, including a hypocaloric diet and regular exercise, aiming for a 5-10% reduction in body weight, as recommended by the American Gastroenterological Association 1.
Treatment Options
The treatment options for Steatosis (Fatty Liver Disease) can be broken down into the following:
- Lifestyle modifications:
- Weight loss: aiming for a 5-10% reduction in body weight, with a hypocaloric diet targeting 1200-1500 kcal/d or a reduction of 500-1000 kcal/d from baseline 1
- Diet: adopting a Mediterranean-style diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, while limiting processed foods, sugar, and saturated fats 1
- Exercise: regular physical activity of at least 150 minutes per week of moderate exercise, with aerobic exercise and resistance training effectively reducing liver fat 1
- Management of comorbidities:
- Diabetes: controlling blood sugar levels with appropriate medications as prescribed by your doctor
- High cholesterol: managing lipid profiles with appropriate medications as prescribed by your doctor
- Hypertension: controlling blood pressure with appropriate medications as prescribed by your doctor
- Avoidance of alcohol: completely avoiding alcohol, especially if you have alcoholic fatty liver disease 1
Additional Recommendations
Additional recommendations for the treatment of Steatosis (Fatty Liver Disease) include:
- Discontinuation of medications that may worsen steatosis, such as corticosteroids, amiodarone, methotrexate, tamoxifen, estrogens, tetracyclines, and valproic acid 1
- Consideration of referral for liver biopsy if patient has risk factors for NASH and advanced fibrosis, including diabetes and/or metabolic syndrome 1
- Consideration of pharmacotherapy if patient has biopsy-proven NASH without cirrhosis and no absolute contraindications 1
- Regular follow-up with your healthcare provider to monitor your liver health and adjust treatment as needed 1
From the Research
Treatment Options for Steatosis (Fatty Liver Disease)
The treatment options for Steatosis (Fatty Liver Disease) include:
- Lifestyle modifications, such as weight loss, improved diet quality, and increased physical activity/exercise 2, 3, 4, 5, 6
- Pharmacologic treatment options, although none have been approved for treatment in the United States 2
- FDA-approved anti-obesity medications as adjunct therapy for patients with NAFLD who are overweight and obese 5
Lifestyle Modifications
Lifestyle modifications are the cornerstone of treatment for NAFLD, and include:
- Weight loss of 5% to >10% 2, 5
- Improved diet quality, such as the Mediterranean diet 3
- Increased physical activity/exercise, including aerobic activity and resistance training 3, 4
- Reduced sedentary behavior and improved sleep habits 3
Pharmacologic Treatment Options
Pharmacologic treatment options are being studied, but none have been approved for treatment in the United States 2. However, FDA-approved anti-obesity medications may be considered as adjunct therapy for patients with NAFLD who are overweight and obese 5.
Special Considerations
It is essential to consider a multidisciplinary approach for successful management of NAFLD, including lifestyle modifications and careful selection of patients for pharmacologic interventions 2. Additionally, future management guidelines should consider the heterogeneity of MAFLD and specialized models of care that coordinate the health workforce to manage the increased and growing MAFLD population 3.