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The #1 Cause of Fatty Liver Disease, Say Experts

This is what’s causing serious harm to your liver.
FACT CHECKED BY Emilia Paluszek

Approximately 100 million Americans have nonalcoholic fatty liver disease, according to the American Liver Foundation. "Fatty liver disease in fact is on the rise," says Jamile Wakim-Fleming, MD, Director of Cleveland Clinic's Fatty Liver Disease Program. "When I first joined the Cleveland Clinic 2002, we were busy dealing with hepatitis C. Fatty liver was barely talked about. In the last 15 years, we have found a cure for hepatitis C so we don't see it as much. Now, we see more of fatty liver disease." Here are the main causes of fatty liver disease, according to doctors. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Metabolic Syndrome

middle-aged man chatting with doctor

Metabolic syndrome (high cholesterol, triglycerides, blood pressure, and insulin resistance) are strongly linked to fatty liver disease. "Metabolic syndrome may be the most common and serious condition you've never heard of," says Robert H. Shmerling, MD. "While each component of metabolic syndrome can cause health problems on its own, a combination of them powerfully increases the risk of having cardiovascular disease (including heart attacks and stroke), diabetes,liver and kidney disease, [and] sleep apnea. And this only a partial list. It's likely we'll learn about other health risks associated with metabolic syndrome in the future."


Type 2 Diabetes

Young diabetic woman checking her blood sugar levels.

"Diabetes raises your risk of nonalcoholic fatty liver disease, a condition in which excess fat builds up in your liver even if you drink little or no alcohol," says M. Regina Castro, MD. "This condition occurs in at least half of those with type 2 diabetes. It isn't clear whether the condition appears more often in people with type 1 diabetes than in the general population because obesity, which is a risk factor, occurs with similar frequency in both groups. Other medical conditions, such as high cholesterol and high blood pressure, also raise your risk of nonalcoholic fatty liver disease."


Too Much Carbs

eating carbs

A diet heavy in carbohydrates is linked to fatty liver disease, doctors say. "If you eat too many carbohydrates and proteins, they can be converted to triglycerides," says gastroenterologist Deepa Shah, MD. "These are stored in the fat cells, and can be deposited in the liver. Insulin resistance can lead to increased triglycerides and increased uptake of fatty acids in the liver, causing further accumulation of liver triglycerides."


Being Overweight

overweight woman at home lying on the floor, laptop in front of her, prepared to work out on mat according to video

Being overweight or obese is one of the main causes of fatty liver disease—if not the main cause—experts say. "75%, three quarters of the patients who have fatty liver disease are overweight," says Dr. Wakim-Fleming. "So what drives the fatty liver disease is being overweight. So the last 15, 20 years has shown a parallel rise in weight and in fatty liver disease because they go hand in hand. That trend occurs in children as well as in adults. For now, it's involving about 25% for the population in the United States and worldwide, and is expected to double in the next 15 years. So this is becoming a very serious issue, and it's becoming the leading cause of end-stage liver disease, cirrhosis and transplantation, one of the leading causes along with alcohol."


How To Treat Fatty Liver Disease

woman holding liver

It's important to reverse fatty liver disease before it causes serious damage, experts say. "That's a very, very common question, and sometimes we are frustrated because we tell our patients to do a few things," says Dr. Wakim-Fleming. "Number one, since most of the time it is tied to obesity, we want them to lose weight. If they have diabetes, we want to treat the diabetes. If they have high blood pressure, we want to treat the high blood pressure. That vicious circle of the metabolic syndrome, we need to break it. If they have abnormal lipid profile, their cholesterol, triglycerides, LDL are elevated, we want to treat those. All of these help because all these factors, the diabetes, the blood pressure, abnormal lipid profile, maybe some endocrine disorders such as hypothyroidism, all of those contribute to deposit of fat in the liver, so we want to treat each one of these elements to break that cycle and help the fatty liver." Eating a Mediterranean diet and drinking up to three cups of coffee a day may also support liver health

Ferozan Mast
Ferozan Mast is a science, health and wellness writer with a passion for making science and research-backed information accessible to a general audience. Read more about Ferozan