Fatty liver disease occurs when fat makes up too much of the liver’s weight. A healthy liver contains little or no fat; when fat accumulates, it can cause inflammation that, over time, may lead to scarring (fibrosis) and eventually cirrhosis. There are two main types: metabolic dysfunction–associated steatotic liver disease (MASLD, formerly non-alcoholic fatty liver disease or NAFLD), which is linked to metabolic factors, and alcohol-related liver disease, which is caused by heavy alcohol use. MASLD is now one of the most common liver conditions in the United States.
What are the symptoms of fatty liver disease?
Fatty liver disease is often called a “silent” condition because many people have no symptoms at all, especially in the early stages. When symptoms do appear, they can include:
- Fatigue or a general feeling of being unwell
- Discomfort or fullness in the upper right side of the abdomen
- Unexplained weight loss (in more advanced disease)
- Weakness
Because symptoms are usually absent, fatty liver is frequently discovered incidentally — through abnormal liver blood tests or imaging done for another reason. That is exactly why proactive evaluation matters if you have risk factors.
What causes fatty liver disease, and who is at risk?
MASLD is closely linked to metabolic health. You are at higher risk if you have obesity or excess weight (especially around the abdomen), type 2 diabetes or insulin resistance, high cholesterol or triglycerides, high blood pressure, or metabolic syndrome. Alcohol-related fatty liver, by contrast, results from heavy or prolonged alcohol use. Many people have overlapping risk factors, which is part of why an accurate diagnosis guides the right treatment plan.
Is fatty liver disease serious?
It can be, which is why it should not be ignored. Simple fatty liver (just fat, without much inflammation) is often manageable and even reversible with the right changes. But in some people it progresses to MASH (formerly NASH) — fatty liver with inflammation and liver-cell damage — which can advance to fibrosis and cirrhosis. The good news is that catching it early, before significant scarring develops, gives you the best chance to stop or reverse the process. Assessing how much scarring is present is a key part of the evaluation.
How is fatty liver disease diagnosed?
At Orlando Gastroenterology, we diagnose and stage fatty liver disease without surgery. Evaluation typically includes liver blood tests, imaging, and FibroScan — a quick, painless scan that measures both liver stiffness (a marker of scarring) and liver fat. FibroScan lets our physicians see how advanced the disease is and track it over time, often avoiding the need for a liver biopsy. We also screen for the underlying metabolic factors — diabetes, cholesterol, and others — that drive the condition.
What do your FibroScan results mean?
FibroScan gives us two numbers in a single painless scan that takes about ten minutes and requires no needles or sedation.
The first measures liver stiffness, which reflects scarring, or fibrosis. Low readings suggest little to no scarring. Higher readings point towards advanced fibrosis or cirrhosis and change how closely we need to monitor you. The second number estimates how much fat is stored in the liver, which is what tells us whether treatment is working.
This matters because fat in the liver is reversible and scarring is much harder to undo. Repeating the scan after six to twelve months of treatment shows whether the two numbers are moving in the right direction — and for most patients they do, which is the most encouraging thing we can show someone with this diagnosis. Our guide to diet and exercise for a healthier liver covers the changes that move them most.
How is fatty liver disease treated?
There is no single pill that cures fatty liver disease, so treatment focuses on reducing liver fat and controlling what causes it. For most patients, the most effective step is gradual, sustained weight loss through a healthier diet and regular physical activity — even a modest reduction in body weight can meaningfully lower liver fat and inflammation. Our team also works to control diabetes, high cholesterol, and blood pressure; advises reducing or eliminating alcohol; reviews medications; and, when appropriate, discusses newer therapies for MASH. We build a realistic plan and monitor your liver over time with FibroScan so you can see your progress.
When should you see a gastroenterologist in Orlando?
If you have been told your liver enzymes are elevated, that you have a “fatty liver” on an ultrasound or CT scan, or you have diabetes, obesity, or high cholesterol, it is worth having a gastroenterologist evaluate your liver. Early assessment with FibroScan is simple and painless, and it gives you a clear picture before any scarring becomes advanced. Orlando Gastroenterology offers evaluations across our Orlando, Clermont, Kissimmee, and East Orlando offices.
