Does weight loss reverse a fatty liver?
The short answer is yes.
Nonalcoholic fatty liver disease, which affects about one in five adults in the United States, is tightly linked to the obesity epidemic. There are no drugs to treat the disease, so most clinicians recommend that patients focus on lifestyle changes that produce weight loss, like diet and exercise, to improve their prognoses. Unchecked, fatty liver disease can lead to liver failure.
In its guidelines on fatty liver disease, the American Association for the Study of Liver Diseases notes that patients need to lose about 3 percent to 5 percent of their body weight to see reductions in liver fat. But the association says more weight loss — up to 10 percent — is needed to improve more severe symptoms like inflammation in the liver.
Clinicians have long recommended weight loss to fatty liver patients on the assumption that it could be very helpful. But only recently have studies begun to demonstrate just how powerful losing weight can be, said Dr. Amy Kim, a hepatologist and assistant professor at Johns Hopkins School of Medicine.
In a study published in the journal Gastroenterology in August, scientists recruited 293 patients and looked at what happened when they followed exercise and diet programs for a year. The patients all had an advanced form of fatty liver disease in which the liver becomes scarred and inflamed, known as nonalcoholic steatohepatitis, or NASH.
Among those who lost 10 percent or more of their body weight, “90 percent had resolution of NASH, and 45 percent had regression of fibrosis,” or scarring, the authors reported.
“In clinic, we always say weight loss,” Dr. Kim said. “But this was a large prospective trial that confirmed that.”
“The more weight loss there is, the better the improvement,” she added.
