How serious is a fatty liver?

Written by: Professor Aftab Ala
Published: | Updated: 16/01/2024
Edited by: Cameron Gibson-Watt

Fatty liver is a condition caused by the accumulation of fat in the liver cells. It is increasingly recognised in the western world, affecting more than 33 per cent of adults. Fatty liver disease is considered present when more than 5 per cent of liver cells are laden with excess fat. 


Professor Aftab Ala, renowned consultant gastroenterologist and hepatologist, provides an overview of the condition and what we can do to prevent this disease from progressing.


Man eating a burger, which can lead to a fatty liver disease


What causes fatty liver?


In the majority of cases, fatty liver occurs in people who are overweight, those who have a high-calorie intake, consume excess fructose and live a sedentary lifestyle. This condition is also associated with diabetes mellitus, insulin resistance and raised lipid levels in the blood.


If fatty liver isn’t addressed, it can scar the liver and progress to more serious conditions and health problems.


What are the symptoms of fatty liver?


Most people with fatty liver show no symptoms. It is often diagnosed after performing a liver test or an ultrasound scan of the liver.


If fatty liver remains undetected, then the patient might start showing symptoms of cirrhosis. Some of these symptoms include tiredness, jaundice, loss or lack of appetite, weight loss, bleeding easily and swelling in the legs.


How can it be diagnosed?


Fatty liver is typically diagnosed after performing a routine blood test of the liver. People who are overweight or have diabetes are often advised to have their liver checked by having their blood tested and an ultrasound scan done of the liver.


The condition leads to inflammation of the liver cells which would cause abnormal liver test results. Up to 5 per cent of people with fatty liver will show abnormal liver test results, which is how it is normally detected.


If the liver tests show an abnormality, the person will need to be referred to a gastroenterologist for further evaluation in order to rule out other causes of the abnormal liver results. The patient will also need to be assessed for any damage to the liver by using a scan called FibroScan® and having blood tests to look for any scarring on the liver.


How to treat a fatty liver?


Unfortunately, whilst there is no agreed curative treatment for fatty liver, there is significant work in clinical trials in this area and emphasis should be on prevention by adopting a healthy lifestyle.


In people who are overweight, there are opportunities to be assessed in weight management clinics which offer comprehensive advice about lifestyle and weight management. If a person can lose at least 10 per cent of their weight, it has been shown to improve liver function.


There are certain drugs that can benefit in established cases of fatty liver, particularly when the liver tests are abnormal. The patient will need to see a gastroenterologist who specialises in liver disease to justify the use of these drugs.


There are some newer drugs under active research for fatty liver and these may be available in the future.



If you are concerned about fatty liver, arrange a consultation with Professor Aftab Ala, an expert in fatty liver, liver disease, liver function tests and FibroScan®, via his Top Doctors profile today.

By Professor Aftab Ala

Professor Aftab Ala is an internationally recognised consultant gastroenterologist and hepatologist who specialises in liver disease, liver function tests, FibroScan, colonoscopy, gastroscopy and SIBO. His private practices is based at Nuffield Health Guildford Hospital, Mount Alvernia Hospital and Spire Clare Park Hospital, with NHS base at the Royal Surrey NHS Foundation Trust, Guildford and Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London. 

FibroScan, one of Professor Ala's areas of expertise, is a non-invasive technique that allows the assessment of hepatic fibrosis, as well as quantification of liver fat. It's fast, reliable and is alternative to a biopsy, which takes longer than a FibroScan test and has potential complications.   

Professor Ala is highly qualified, with an MB BS from Charing Cross and Westminster Medical School (Imperial College, London) an MD (United States Medical Licensing Examination) and a PhD in hepatology from University College London, where he won a National Wellcome Trust Research Training fellowship in immune and inflammatory medicine mechanisms linking liver and gut disease. Following specialist training in global centres of excellence at King's and Royal Free Hospitals, he was awarded a Certificate of Completion of Specialist Training (CSST) in gastroenterology and internal medicine.

He undertook further focused training as advanced hepatology fellowship to Mount Sinai Hospital in New York from 2003 to 2004, building international expertise on rare liver diseases, chronic liver disease and liver/bowel transplantation. Professor Ala is a fellow of the Royal College of Physicians, London the Chair of the Gastroenterology and Hepatology, Clinical and Experimental Medicine Department at the University of Surrey and a consultant hepatologist at Royal Surrey and Kings London.

He has written and contributed to over 200 peer-reviewed original medical articles and oral presentations. He has supervised PhD students at the University of Surrey and King's College London leading research programmes supported by National (NIHR and UKRI-MRC) and International funding in genetic metabolic liver disease and inequalities of health in which he has an active track record of scientific achievement and running international and national clinical trials, including first in human studies.

He is a member of numerous scientific committees in his field, and is the lead for hepatology at the National Institute of Health and Research (NIHR) for Kent, Surrey and Sussex (South East England). Professor Ala is also a previous group member for hepato-pancreatic biliary (HPB) NHS England's South East coast Clinical Reference Group, NICE Guidelines on Hepatitis B, Clinical Advisor to the NHS England and currently British Liver Trust-

Professor Ala is a member of various professional organisations including the Royal College of Physicians London, the British Society of Gastroenterology (BSG) British Association for the Study of the Liver (BASL). He is the lead of the Wilson's Disease and Rare Liver Disease Special Interest Group for BASL, member of the American Association for the Study of the Liver (AASLD) and the European Association for the Study of the Liver (EASL).

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