Does My Liver Look Fat in This?

06/24/2014 03:04 pm ET Updated Dec 06, 2017

Obesity presents yet another deadly risk.

There's another reason to start working out and grabbing a salad instead of pizza for your next meal. Your liver could be dying for a diet.

For years, news articles have been reporting about the cruel practice of force-feeding ducks to turn their livers into fatty foie gras for restaurant menus. And now, it's being reported that humans are over-feeding themselves in a similar way -- by overeating sugar and fatty foods! As a personal trainer, it's important for fitness professionals, doctors and patients to all realize this might be a more powerful reason to get fit than just getting into your "skinny jeans."

The obesity epidemic is not just increasing the risk of heart disease and diabetes; it's affecting our livers too. According to the American Liver Foundation (ALF), non-alcoholic fatty liver disease already is "the most common liver disease in most of the Western world."


NAFLD is estimated to affect more than 30 million people in the United States, according to data presented at the International Liver Conference in 2011 and the World Journal of Gastroenterology, AALSD hepatology .

"Non-alcoholic fatty liver disease is currently the most common liver disease in most of the Western world, affecting 30 percent of adults and 10 percent of children -- and this number is growing," warns Tamar Taddei, M.D., associate professor of medicine, section of digestive diseases at the Yale School of Medicine and a member of the American Liver Foundation's medical advisory committee. She cites sources like the report "Nonalcoholic Steatohepatitis: Summary of an AASLD." "NAFLD is estimated to affect more than 30 million people in the United States. By 2030, an estimated 50 percent of Americans will be affected."

The Facts:

According to ALF, NAFLD is identified by a buildup of extra fat in liver cells (steatosis) that is not caused by alcohol. Although it is normal for the liver to contain some fat, the term "fatty liver" is used when a person's liver is made up of more than 5 percent - 10 percent fat.

NAFLD most often develops in people who are overweight or obese, have Type 2 diabetes, high cholesterol, high triglycerides or polycystic ovary disease. NAFLD can be found in more than 25 percent of obese individuals; Hispanics have the highest rates, followed by non-Hispanic whites. Additional risk factors include increasing age, hypertension and rapid weight loss. ("Obesity-Associated Nonalcoholic Fatty Liver Disease").



NAFLD is asymptomatic. When the accumulated fat causes inflammation of the liver, it is called non-alcoholic steatohepatitis (NASH). Patients with NASH are at risk for the development of progressive scarring that may lead to cirrhosis of the liver. According to the US National Library of Medicine, symptoms of cirrhosis may include fatigue; abdominal discomfort; yellowing of the skin and eyes (jaundice); swelling of the legs (edema) and fluid buildup in the abdomen (ascites); and mental confusion (hepatic encephalopathy). In many cases, the first signs of illness do not occur until significant liver damage has developed.


If you think you could be at risk, see your doctor, and ask for a routine blood test to check your liver function and follow their advice if it comes back abnormal. You may need imaging or a liver biopsy. To find a leading liver specialist in your area, call the ALF national helpline 1-800-GO-LIVER (1-800-465-4837) or visit

The best way to avoid NAFLD is to exercise at a moderate level for a half an hour, three to five days a week. While treatments are in development, currently there are no medications for NAFLD.

Since obesity is a major risk factor, doctors recommend diet and exercise with the goal of at least a seven percent reduction in body weight. Most nutritional intervention guidelines for NAFLD recommend a moderately low-calorie diet of about 1,000-1,200 calories per day for women and 1,200-1,600 calories per day for men. ("The Role of Diet and Nutritional Intervention for the Management of Patients with NAFLD").

Eat foods low in sugar and fat, and higher in fiber, like whole grains. Focus on fruits, vegetables, and lean protein, like fish, chicken, beans and nuts. Avoid alcohol, and up your intake of water, which shouldn't be a problem with all the extra exercising you'll be doing.

Additionally, children are often at risk, about one-third of children in the U.S. are overweight or obese and developing NAFLD at a young age. It's a good idea to get your whole family eating right and moving.

Depending on the severity of NAFLD, treatment for children focuses on lifestyle and dietary changes that encourage weight loss and overall health.

If treated early with healthy lifestyle changes, fatty liver disease can be reversed before severe liver damage occurs. I'll drink (out of a water bottle, post-workout) to that!