Non-Alcoholic Fatty Liver Disease: Can You Reverse It?

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a condition that used to be called non-alcoholic fatty liver disease (NAFLD). It means there’s a buildup of fat in your liver. But unlike other types of liver disease, there’s no damage to the organ in MASLD. So you can take steps to reverse the condition before it becomes a more serious problem.

Weight Loss

Research suggests that losing excess weight is the single best thing you can do to control or reverse MASLD. A good goal is to lose 10% of your total body weight, but even a loss of 3% to 5% can improve your liver health.

Talk with your doctor about the best way for you to lose weight safely and effectively. Options can include:

• Diet
• Exercise
• Weight loss surgery
• Weight loss medication

Treat Other Health Problems

A fatty liver is linked to several other health conditions. Treat those issues and you can help reverse MASLD, too. Conditions might include:

• Diabetes
• High cholesterol
• High triglycerides (fat in the blood)
• Sleep apnea
• Polycystic ovary syndrome
• Underactive thyroid, or hypothyroidism
• Hypogonadism or growth hormone deficiency

Change How You Eat

Shifts in your diet may help you lose weight, but there are other payoffs as well. They can improve your general health and lower the amount of fat in your liver.

Some adjustments you can make:

• Eat more fruits and vegetables.
• Eat more fish.
• Eat more high-fiber foods.
• Don't eat too many carbohydrates.
• Limit sugar.
• Limit saturated and trans fats.
• Limit salt.

And savor your morning cup of coffee. Scientists believe it may lower liver inflammation, though they need more research to know for sure.

Ease Stress on Your Liver

Alcohol can cause fat to build up in your liver. It also can damage the organ. You should avoid alcohol if you have MASLD.

If you don’t think you can stop using it completely, it still helps to just drink less. A simple rule is to have less than one drink per day if you’re a woman, and less than two per day if you’re a man.

Some over-the-counter medicines also strain your liver. Follow the dose directions when you take acetaminophen to make sure you don’t take too much. And make sure you read the labels of all the medicines you take -- acetaminophen is in many cold medications and prescription painkillers.

Talk to your doctor about all the drugs and supplements you take. Some people with liver problems should not take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.

Medications to Consider

No drugs are approved specifically to treat MASLD. One drug, resmetirom (Rezdiffra), is approved to treat the advanced stage of the condition, called metabolic dysfunction-associated liver disease (MASH) with greater degrees of fibrosis. This happens when there's inflammation and damage to the liver along with fat buildup.

There are some other medications and supplements you and your doctor may want to discuss.

You may need vaccines to protect you against hepatitis A and B, viruses that can damage your liver. It’s also important to get a flu shot each year.

Some studies have found that vitamin E seemed to improve how well some people’s livers worked, but the science is not settled. If you’re interested in trying this supplement, talk to your doctor first. It may not be safe for everyone, and it has been linked to prostate cancer.

Keep in touch with your doctor about your condition. Researchers are working on new drugs to treat MASLD, and one of them may be right for you.