Here’s the usual scenario. You are fat and having some vague symptoms of fatigue, poor concentration, nausea, poor appetite, fullness, and some ache or discomfort in your tummy (particularly the upper right aspect)—or you’re just having a routine mandatory executive health exam, and your doctor orders some tests. Then, incidentally, the ultrasound shows your liver is a plus size.
What is fatty liver? It’s the liver with fatty deposits in excess. A normal liver has some fat in it but not much. You’ve got to expect some fat because the liver processes a lot of fats. But when the liver cannot handle a lot of fat, the metabolic highway can pile up a lot of fat in the liver, fattening it up in the process.
The trouble with fatty liver is:
it signals the past or an ongoing underlying problem—something made (or is making) it fat; and
it can signal what the future may bring—it can cause potential problems (say, cirrhosis).
Are you a habitual moderate-to-heavy alcoholic beverage drinker? Do you have an alcoholic history? Bad news: a majority of alcoholics develop fatty liver (technically called alcoholic fatty liver disease). Genes also play a role as they can determine how much the body can handle alcohol and how much one can become addicted to it. Genes aside, diet, excess body iron and fat, hepatitis, and obesity can also contribute to having an alcoholic fatty liver.
Non-alcoholics can still get fatty liver. In fact, nonalcoholic fatty liver disease (NAFLD) is probably the most common long-lasting liver problem in the world. In most cases, the problem is decidedly benign. In others, it can lead to some inflammation (called steatohepatitis), which can cause liver damage.
Some factors that are associated with a risk of getting NAFLD include obesity, certain meds (such as amiodarone, methotrexate, corticosteroids, tetracycline, and tamoxifen), hepatitis, genetic liver disorder, immune and metabolic system disorders, calorie- and fat-rich diet, malnutrition, middle or old age, obesity, rapid weight loss, diabetes or pre-diabetes, hypertension, abnormal blood lipid/cholesterol profile, bacterial overgrowth in the gut, and genes. How about pregnancy? Rarely but yes. In some cases, however, no risk factor can be identified at all.