Fatty liver disease

Also called steatohepatitis or steatosis.

Fatty liver disease is a build-up of fat in the liver. For most people, it causes no symptoms and no problems but in some people, the fat damages the liver cells and affects how well the liver works. There are two types of fatty liver disease – alcohol-related fatty liver disease and non-alcoholic fatty liver disease (NAFLD).

Key points

  1. Fatty liver disease is the build-up of fat in the liver (too much fat in the liver).
  2. There are 2 types of fatty liver disease – alcohol-related fatty liver disease and non-alcoholic fatty liver disease (NAFLD).
  3. There are an increasing number of people with fatty liver disease that is not caused by alcohol. 
  4. Fatty liver disease is more common in people of Indian and Chinese descent compared with European groups. It is also more common in Pasifika people.

Causes of fatty liver disease

Alcohol-related fatty liver disease

Excess alcohol is the main cause of alcohol-related fatty liver disease. Fatty liver develops in 46–90% of heavy alcohol users. For some people, 5 to 10 standard drinks per week may be enough to cause fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD)

Possible causes of non-alcoholic fatty liver disease are:

Symptoms of fatty liver disease

You may have no symptoms in the early stages of fatty liver disease. Most people who have fatty liver disease feel fine and don't know that they have it. Some people get symptoms such as: 

  • feeling weak and tired all the time
  • weight loss 
  • a pain or discomfort in the upper right part of your stomach. 

Diagnosis of fatty liver disease

It can be hard to diagnose fatty liver disease, especially when the disease is still in its early stages. Your doctor may be able to suspect it after examining your symptoms and medical history. 

Diagnosis is usually confirmed through:

Treatment of fatty liver disease

The treatment of fatty liver disease will depend on the cause and the diagnosis.

  • In alcohol-related fatty liver disease, alcohol abstinence is the main treatment option.
  • In non-alcoholic fatty liver disease, the main treatments are lifestyle changes such as:
    • gradual weight loss   
    • regular exercise 
    • reduction of total cholesterol level
    • diabetes control.

Learn more

The following links provide more information about fatty liver disease. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Fatty liver and causes Gastro-Info, NZ
Fatty liver MacMurray Centre, NZ
Steatohepatitis and steatosis (fatty liver) Patient Info, UK
Information about Fatty Liver Disease Gastroenterological Society of Australia
What is fatty liver disease? The Hepatitis Foundation of New Zealand
Non-alcoholic fatty liver disease NHS, UK

Additional resources for healthcare professionals

NAFLD (Non-alcoholic Fatty Liver) fibrosis score MDCalc
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (requires registration and log-in) BMJ Learning, UK
Coppell K, Schultz M, McCormick S, Sharp K. Non-alcoholic fatty liver disease (NAFLD) – dietary triggers and treatment approaches Edgar Diabetes and Obesity Research, University of Otago, NZ

Credits: Health Navigator Editorial Team.