Fatty liver disease

Fatty liver disease is the most common form of liver disease. The condition develops when extra fat builds up in your liver. There are two main types: metabolic dysfunction-associated steatotic liver disease (MASLD), formerly called nonalcoholic fatty liver disease (NAFLD), and alcohol-associated fatty liver disease (AFLD). Both types can range from mild fat buildup (hepatic steatosis) to metabolic dysfunction-associated steatohepatitis (MASH), the more serious form of MASLD.

Fatty liver disease is treated by gastroenterologists and hepatologists who specialize in diagnosing and managing liver conditions. At Penn Medicine, our liver disease care experts offer advanced testing, individualized care, and access to research on new treatments, including ongoing studies exploring GLP-1 medications and other therapies for fatty liver disease.

In the early stages, many people with fatty liver disease don’t notice symptoms. The condition is often found during routine blood tests. When symptoms do appear, the most common ones can be fatigue and feeling pain or fullness in the upper right abdomen.

Additional symptoms of fatty liver disease may include:

• Weakness
• Loss of appetite
• Nausea
• Yellowing of the skin or eyes (jaundice)
• Fluid buildup and swelling in the legs and abdomen

If the disease progresses to MASH, symptoms can become more noticeable and may lead to scarring (cirrhosis), liver failure, or liver cancer.

Fatty liver disease treatment focuses on lowering liver fat, reducing inflammation, and preventing long-term damage. Your provider will tailor your care plan based on your type of fatty liver disease and your overall health.

For people with MASLD, making healthy lifestyle changes like losing weight, eating a healthy diet, and exercising can slow down or even reverse fat buildup. Some GLP-1 medications, primarily used for managing diabetes and weight, are now approved to treat MASH in adults, and they can help reduce liver fat and inflammation. Talk with your provider about whether these medications may be helpful as part of your care plan.

If you have AFLD, the most important step is stopping alcohol use. Penn Medicine specialists offer coordinated support, including treatment for alcohol use disorder, nutrition services, and care for alcohol-related liver injury.