How Serious Is Fatty Liver Disease? Who Gets It? What Can You Do?

If the process of turning sugar into fat goes on long enough, liver cells start to become inflamed. The liver protects itself by isolating inflamed fat-filled cells through a process called fibrosis. These fibers can accumulate until the liver is in a state of cirrhosis. The liver becomes so "stringy" that oxygen from the bloodstream doesn't reach its innermost parts. The "centrilobular" liver ceases to function normally. It can still process nutrients, but it accomplishes this with pro-oxidants. These highly charged chemical entities damage the liver even more, causing even more fibrosis, leading to even worse cirrhosis. 

At the same time, other parts of the body start storing the fats that can't be stored in the liver. Unfortunately, these fats tend to accumulate in the intima, or lining, of major arteries. The walls of arteries get thicker and thicker and thicker. This makes them stiffer and stiffer, less able to continue to conduct blood should you get a blood clot. Your risk of heart attack rises significantly when you develop fatty liver disease. Over a period of 10 to 12 years, fatty liver can elevate your risk of heart attack by about 300 percent. You will be acutely aware of the effects of fatty liver disease (there's essentially no such thing as fatty liver pain, for instance), but you may never have a hint of fatty liver symptoms.

Just how many people have fatty liver disease? A recent study found that one out of every four people on earth has the condition.

• The highest rates of fatty liver disease are in South America and the Middle East. These are also the parts of the world where it is least likely to be diagnosed and treated.
• The lowest rates of fatty liver disease occur where famine is still an issue, mostly in Africa.
• People who get fatty liver disease have about a 1-1/2 percent risk of developing liver cancer in any given year. That's about a one in two chance over a lifetime (after diagnosis) for most people who have the condition. That's many times higher than the risk for people who don't develop fatty liver disease.
• People who get fatty liver disease are at higher risk for heart attack and stroke, and less likely to survive heart attack and stroke when they occur.

People who have fatty liver disease almost always are people who are obese. It's not really accurate to say obesity "causes" fatty liver disease. The same factors are at work in both the liver and the fat mass. It is accurate to say that overeating sugars causes fatty liver disease. However, losing weight can reverse fatty liver disease, sometimes in just a few weeks. You can reduce the stress on your liver by:

• Losing body fat, not just weight. If you (like many South Asians) are of normal or low body weight but you have a fat tummy, you still need to lose more body fat.
• Losing body fat by lifestyle changes. To achieve a fatty liver diet you just need to eat less. It's not enough to just exercise more. Otherwise, you will never get control of the excess insulin that keeps fat locked in liver cells and fat cells.
• Losing at least 5 percent of your total weight. That's all it takes to reverse the process that gives you fatty liver. Losing 10 percent of your total weight will also have a beneficial effect on diabetes.

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Fatty liver disease is almost never directly deadly. For this reason, it's often missed even by the most attentive doctors. Getting your weight down by eating less carbohydrate may save your liver and prolong your life.