Quick answer: Fatty liver usually causes no symptoms and is often found by chance on a blood test or scan. Most people have the earliest stage, which does not usually cause problems, and healthy lifestyle changes can reduce the fat in the liver. It becomes more concerning when it causes inflammation or scarring. See a doctor promptly if you have yellow skin or eyes, a swollen abdomen or legs, confusion, vomiting blood, or black stools.
Emirates European Hospital provides liver disease care in Sharjah, including assessment of fatty liver and abnormal liver findings. Being told you have fatty liver does not mean your liver is failing. The important questions are why the fat has built up, whether there is any damage, and what can be done to stop it getting worse.
What Is Fatty Liver Disease?
Fatty liver disease means too much fat has built up in the liver. A small amount of fat in liver cells is normal, but too much can be a problem. The main type not caused by heavy alcohol use used to be called non-alcoholic fatty liver disease, or NAFLD. It is now also called metabolic dysfunction-associated steatotic liver disease, or MASLD, so you may see either name on a report.
The other main type is alcohol-associated liver disease. Your doctor will ask about alcohol because it helps show which type you have. It is possible to have both.
What Are the Stages of Fatty Liver?
Fatty liver disease has four stages. Most people only have the first stage, and only a small number progress to more serious liver damage.
- Simple fatty liver (steatosis): Fat has built up, but the liver is not damaged.
- Steatohepatitis (MASH, previously called NASH): Fat has caused inflammation. The liver is not yet seriously damaged, but there is a risk it could get worse.
- Fibrosis: The liver has some scarring, although it usually still works well. This is an important time to try to stop further damage.
- Cirrhosis: Severe damage affects how the liver works. It can lead to serious problems including internal bleeding, liver failure and liver cancer.
What Symptoms Can Fatty Liver Cause?
Usually none. Many people have it without realizing, and it is often found when tests are done for another reason. Some people may have cirrhosis caused by fatty liver and still have no symptoms, which is why normal-feeling health does not rule out liver damage. When symptoms do occur, they can include:
- Feeling very tired
- Feeling generally unwell
- Pain or discomfort in the upper right side of the abdomen, under the ribs
Who Is More Likely to Get Fatty Liver?
Fatty liver is very common and is closely linked to metabolic health. You are more likely to have it if you:
- Are overweight or have obesity, particularly with extra fat around the waist
- Have insulin resistance or type 2 diabetes
- Have high blood pressure
- Have high cholesterol or high triglycerides
- Have polycystic ovary syndrome
- Do not have a healthy diet or are not very physically active
- Are over 50
Having more of these conditions increases the chance of developing the inflammatory form of the disease. Genes may also play a part, so fatty liver can occur in people who do not fit this pattern.
When Should I Worry About Fatty Liver?
See a doctor if you think you may have fatty liver, or if you have a higher risk because of the conditions above. A report saying "fatty liver" on an ultrasound, or raised liver enzymes on a blood test, is also a good reason for a review, even when you feel well.
Signs that need prompt medical attention
These symptoms can happen when liver disease is advanced, whatever the cause. Get medical help promptly if you have:
- Yellow skin or yellow whites of the eyes
- A swollen abdomen, legs, ankles or feet
- Itchy skin, or bleeding and bruising easily
- Confusion or difficulty concentrating
- Weight loss without trying or loss of appetite
Vomiting blood or passing very dark or black stools is an emergency. Go to the nearest emergency department or call an ambulance on 998.
How Is Fatty Liver Diagnosed?
Doctors use your medical history, a physical examination, and tests. The aim is to confirm the fat, rule out other causes of liver problems, and find out whether there is any damage.
Medical history and examination
Your doctor will ask about your health conditions, medicines, diet, activity and alcohol intake. They will check your weight, height and waist measurement and look for signs such as an enlarged liver.
Blood tests
Liver function tests can show raised liver enzymes such as ALT and AST. Your doctor may use routine results to calculate scores such as FIB-4 or APRI, which help identify or rule out advanced scarring. Other blood tests can check for different causes of raised enzymes.
Ultrasound and other imaging
Ultrasound, CT and MRI can show fat in the liver. Routine imaging cannot show inflammation or scarring, so a scan on its own cannot tell simple fatty liver from the more serious inflammatory form.
Liver stiffness tests
Elastography is a type of imaging that measures how stiff the liver is. Increased stiffness may be a sign of scarring. Your doctor can advise whether this test is useful in your case and how to arrange it.
Liver biopsy
A liver biopsy takes small pieces of liver tissue for examination under a microscope. It is the only test that can prove inflammation from fatty liver and show clearly how severe the disease is. Doctors do not recommend it for everyone. It may be suggested when other tests point to advanced disease or when another liver condition needs to be ruled out.
Can Fatty Liver Be Reversed?
Healthy lifestyle changes can reduce the build-up of fat in the liver, help repair damage, or stop it getting worse. These changes also lower the risk of related conditions such as cardiovascular disease, chronic kidney disease, high blood pressure and type 2 diabetes. How much improvement is possible depends on the stage of the disease, so ask your doctor what to expect in your case.
How Much Weight Do I Need to Lose?
If you are overweight, weight loss is the main treatment. Losing at least 3% to 5% of your body weight can reduce fat in the liver. You may need to lose up to 7% to 10% to reduce inflammation and scarring. For someone who weighs 90 kg, that is about 3 to 5 kg for the first target and 6 to 9 kg for the second.
Lose weight gradually. Rapid weight loss and malnutrition can make liver disease worse, so crash diets are not a safe shortcut. If you are living with obesity, a specialist may discuss medicines or surgery to help with weight loss.
What Else Helps a Fatty Liver?
- Eat a healthy, balanced diet and watch your portion sizes
- Aim for at least 150 minutes of exercise a week, which is beneficial even without weight loss
- Do not smoke
- Avoid alcohol or follow your doctor's advice on it, because alcohol can add to liver damage
- Keep diabetes, blood pressure and cholesterol under control with your doctor
Are There Medicines for Fatty Liver?
Most people with simple fatty liver need lifestyle changes rather than medicine. People with liver damage need specialist care, which may include medicines such as pioglitazone or vitamin E.
Treatment for more advanced disease is changing. In the United States, the FDA approved resmetirom in 2024 and semaglutide in 2025 for adults with MASH and moderate to advanced scarring, alongside diet and exercise. These are not treatments for simple fatty liver, and they are not suitable for everyone. Availability varies by country, so ask your specialist what applies to you.
Are Supplements or Herbal Remedies Safe?
Talk to your doctor before using dietary supplements, vitamins, or complementary medicines. Some herbal remedies can damage the liver, including products marketed as liver cleanses or detoxes, so do not assume that natural means safe.
How Often Does Fatty Liver Need Follow-Up?
This depends on your stage and your other health conditions. As a general guide, check-ups at least once a year and tests every 2 to 3 years are often advised to monitor the condition. People with fibrosis or cirrhosis need specialist care, and your doctor will set the schedule that suits you.
Questions to Ask Your Doctor
- Is the fat in my liver caused by metabolic health, alcohol, or something else?
- Is there any sign of inflammation or scarring?
- Do I need a test to check for scarring?
- What weight target is realistic and safe for me?
- Do any of my medicines or supplements affect my liver?
- How often should my liver be checked?
Liver Assessment at Emirates European Hospital
Dr. Ghassan Kaddour is a Specialist Gastroenterologist at Emirates European Hospital with more than 35 years of experience in gastrointestinal and liver diseases. Care may include clinical evaluation, laboratory tests, imaging, follow-up, and a treatment plan based on your results.
If an ultrasound or blood test has shown a possible liver problem, or if you have risk factors and want to be checked, you can book an appointment at Emirates European Hospital or call 06 561 9444. The right next step may be blood tests, imaging, lifestyle advice, or specialist follow-up.
This article provides general educational information and does not replace a medical examination, diagnostic tests, or personalized medical advice.
