Patient Instructions for Managing Fatty Liver Disease
You need to lose 7-10% of your total body weight through diet and exercise—this is the only proven treatment that can reverse fatty liver disease and prevent progression to cirrhosis. 1, 2
Your Weight Loss Target
- If you weigh 200 pounds, aim to lose 14-20 pounds over 3-5 months 1, 2
- Lose weight gradually at 1-2 pounds per week maximum—rapid weight loss actually worsens liver disease 1, 2
- Even 5% weight loss (10 pounds if you weigh 200) will improve liver fat, but you need 7-10% to reverse inflammation and scarring 1, 2
Your Daily Diet Plan
Follow a Mediterranean diet pattern every single day: 3, 1, 2
Foods to Eat Daily:
- Vegetables: Fill half your plate at lunch and dinner 3, 1
- Fruits: 2-3 servings of fresh fruit (not juice) 3, 1
- Olive oil: Use as your primary cooking fat and salad dressing 3, 1
- Nuts and seeds: A handful daily as snacks 3, 1
- Fish or white meat: Salmon, tuna, chicken, or turkey as your protein 3, 1
- Whole grains: Brown rice, quinoa, whole wheat bread, oatmeal 3, 1
- Legumes: Beans, lentils, chickpeas several times per week 3
Foods to Completely Eliminate:
- All sodas and sweetened beverages (including fruit juice, sports drinks, sweet tea) 3, 1
- Processed foods and fast food (chips, cookies, frozen meals, drive-through restaurants) 3, 1
- Red meat and processed meats (beef, pork, bacon, sausage, deli meats) 3, 1
- Commercial baked goods (donuts, pastries, cakes, muffins) 3
- All alcohol—even small amounts double your risk of liver complications 1
Your Calorie Target:
- Women: 1,200-1,500 calories per day 1, 2
- Men: 1,500-1,800 calories per day 1, 2
- This creates a 500-1,000 calorie deficit to lose 1-2 pounds weekly 1, 2
Your Exercise Prescription
You must exercise at least 150 minutes per week—this is non-negotiable: 1, 2
Option 1: Moderate-Intensity Exercise
- 150-300 minutes per week (30-60 minutes, 5 days per week) 1, 2
- Examples: Brisk walking, swimming, cycling, dancing 1
- You should be able to talk but not sing during exercise 1
Option 2: Vigorous-Intensity Exercise
- 75-150 minutes per week (25-30 minutes, 5 days per week) 1, 2
- Examples: Jogging, running, fast cycling, aerobics classes 1
- You should only be able to say a few words without pausing for breath 1
Add Strength Training:
- At least 2 days per week: Lift weights, use resistance bands, or do bodyweight exercises (push-ups, squats) 4
- Exercise reduces liver fat even if you don't lose weight, so keep exercising regardless 4
Critical Things You Must Avoid
Stop smoking immediately—smoking increases your risk of liver cancer by 50-80% 1
Avoid these medications that worsen fatty liver: 1
- Corticosteroids (prednisone)
- Amiodarone (heart medication)
- Methotrexate
- Tamoxifen
Managing Your Other Health Conditions
If You Have Diabetes:
- Ask your doctor about GLP-1 medications (like Ozempic, Wegovy) or SGLT-2 inhibitors (like Jardiance)—these help both diabetes and fatty liver 4, 2
- Avoid sulfonylureas and insulin if possible—they increase liver cancer risk 1, 4
If You Have High Cholesterol:
If You Have High Blood Pressure:
- Keep blood pressure below 130/85 mmHg with medication 4
What to Expect and When to Follow Up
- You will see your doctor every 6-12 months for blood tests and liver assessment 1, 4
- Your doctor will calculate a "FIB-4 score" to monitor liver scarring 1, 4
- If your score worsens or you develop complications, you may need referral to a liver specialist 1, 4
Why This Matters
Cardiovascular disease (heart attack and stroke) is actually the most common cause of death in fatty liver patients, not liver failure—this is why controlling blood pressure, cholesterol, and diabetes is just as important as the diet and exercise 2
Your fatty liver is reversible with these lifestyle changes, but you must commit to them permanently, not just for a few months. 3, 5