You may not feel it and there may be no symptoms at all. But deep inside your body, your liver could be quietly storing fat, even if you’ve never touched a drop of alcohol. That’s the unnerving reality of non-alcoholic fatty liver disease (NAFLD), a condition that’s crawling into more lives than ever, silently and steadily.
What exactly do you mean by NAFLD? “It is a condition where fat builds up in your liver, for reasons other than alcohol,” says Dr Narendra Teja Gogireddy, consultant surgical gastroenterologist at Apollo Hospitals, Hyderguda, further adding, “This term is used for patients with chronic lifestyle diseases. In initial stages it is mild and reversible, however it can cause liver damage over time and lead to serious conditions like cirrhosis or liver failure.”
The condition often stems from everyday habits that seem harmless at first; a sedentary routine, meals loaded with sugar and processed carbs, and that familiar struggle with weight gain. “People who drink little or no alcohol may develop NAFLD. People who are overweight or obese frequently exhibit it. The most prevalent type of liver disease in the world today is NAFLD. Although NAFLD in its early stages is typically benign and asymptomatic, it can develop into more severe forms such as Non-Alcoholic Steatohepatitis (NASH), which involves damage and inflammation of the liver. NASH can result in cirrhosis, scarring (fibrosis), and potentially liver failure or malignancy if treatment is not received,” explains Dr Naveen Polavarapu, senior consultant, medical gastroenterologist, liver specialist, lead, advanced endoscopic interventions & training, clinical director, Yashoda Hospitals, Hyderabad.
What’s alarming is that NAFLD doesn’t discriminate, “Fat can build up in your liver even if you don’t drink alcohol. This happens due to several factors like insulin resistance (often linked with type 2 diabetes or prediabetes), high cholesterol or triglyceride levels, poor diet (especially diets high in sugar and refined carbs), sedentary lifestyle (lack of physical activity), rapid weight loss or malnutrition, certain medications (like corticosteroids or some cancer drugs), hormonal imbalances or metabolic syndrome. These risk factors can lead to fat accumulation in liver cells, potentially causing inflammation, scarring, and liver damage over time if not managed,” says Dr Narendra.
To detect it, doctors typically begin with blood tests and ultrasound, “Blood tests (to check liver enzymes), ultrasound scan (a safe and simple test to see fat in the liver) FibroScan (to check for liver stiffness or scarring) MRI or CT scan Liver biopsy (rare, only if needed to check the level of liver damage),” notes Dr Narendra.
The good news? It’s reversible if caught early. “Yes, in most cases, it can be reversed especially in the early stages through weight loss and healthy lifestyle changes.The key to reversal lies in losing weight gradually (5 –10% of body weight can significantly reduce liver fat), eating a balanced, healthy diet (rich in fruits, vegetables, whole grains, and lean proteins), exercising regularly, controlling blood sugar and cholesterol levels, avoiding sugary drinks and processed foods, these lifestyle changes can reduce fat in the liver, improve liver function, and even reverse early liver damage if addressed in time,” he assures.
But when it comes to medication there is no specific medication for the disease yet. “For the majority of NAFLD instances, there are currently no approved medications. Changing one’s lifestyle is the primary treatment. However, your doctor might prescribe drugs like Rezdiffra (resmetirom), which is FDA-approved for noncirrhotic NASH with moderate to advanced fibrosis, if you develop NASH with extensive liver scarring,” narrates Dr Naveen.
Follow-ups are very important. Dr Naveen adds, “Depending on your risk factors and the severity of your condition, your doctor will usually advise routine follow-up if you have NAFLD. This may include imaging and blood tests every 6 to 12 months. More frequent monitoring can be recommended if you have risk factors for advancement, such as diabetes, obesity, or signs of liver inflammation.”
In the end, your liver doesn’t just respond to alcohol, it also responds to lifestyle changes. It remembers everything including every sugary snack, skipped workout, and long sedentary day you have had. But it also forgives; when you make the choice to change. Because sometimes, the most powerful medicine isn’t in a bottle, but is in the small changes and everyday decisions we make to make our lives better.