Last Updated on May 3, 2021
Though the phrase “fatty liver” may sound like a restaurant specialty (or something from a second-rate nightclub comedian) the term is nothing to joke about. Also known as hepatic steatosis, it occurs when the liver starts to be surrounded by too much fat.
It is one of three conditions1 that can be accelerated by alcohol consumption. The others are alcoholic hepatitis and cirrhosis. Over time—and years of heavy drinking—fatty liver can lead to the latter, more dire illnesses. And the worst cases result in liver failure.
What Causes Fatty Liver?
In most cases, obesity is the prime culprit for developing fatty liver. (And we all know—or should—that alcohol has more calories than many people realize.) Yet for some people, alcohol isn’t an issue, and they develop nonalcoholic fatty liver disease (NAFLD) anyway. Other warning signs are high blood pressure, diabetes, and high lipids.
The disease can develop over time. Between overeating and overdrinking, weight gain can place undue stress on the liver. As Dr. John Morton, Yale’s chief of bariatric surgery, warns, “If you’re drinking and you’re obese, it’s not only additive, it’s probably synergistic. It makes it even worse when you have both things going on, for sure.”
Types of Fatty Liver Disease
Nonalcoholic fatty liver disease2 (NAFLD) occurs when there is fat, but no damage to the liver. On the other hand, nonalcoholic steatohepatitis (NASH) occurs when there is liver inflammation and cell damage. Either can occur due to factors other than alcohol.
But fatty liver disease due to alcohol—alcoholic steatohepatitis or ASH—is a direct result of drinking too much. As noted earlier, continued heavy alcohol use can result in alcoholic hepatitis. And if cirrhosis develops—scarring of liver tissue—it can often lead to death.
Cases Are on the Rise, and in Young People, Too
At the Yale University Fatty Liver Disease Program3, researchers are dedicated to the causes, prevention, and cure of the disease. They have noted, with some alarm, that the disease is affecting younger people. The cause is generally obesity, and affects those with a body mass index (BMI) of 35 or higher.
The clinical director of the program, Albert Do, MD, is seeing younger patients with cirrhosis and adds, “The scary thing is that they’re only in their 30s and 40s.” He cites binge drinking as a cause, and unfortunately, the pandemic has only made things worse. As others (including we at Ria) have noted during the pandemic, many people have been drinking more during quarantine.
During the Pandemic, Sounding the Alarm Bell
Over the past year, many people have been cooped up at home. Sometimes, the temptation to eat and drink occurs out of sheer boredom. But in addition to high-caloric foods, alcohol needs to be on every “caution” list. Grabbing a beer from the refrigerator can be too easy.
As one prominent medical center4 notes, “A lot of people are home a lot more than they used to be. If you’re on a video conference and bored, the pantry or refrigerator is a few steps away. We’re snacking more because we want to pass the time and that can be dangerous.”
This trend is confirmed by the University of Michigan, where researchers have noted a 30% increase in cases of alcoholic liver disease (including fatty liver) over the previous year. Dr. Jessica Mellinger, one of the university’s liver specialists, says, “In my conversations with my colleagues at other institutions, everybody is saying the same thing.”
Tips for Better Liver Health
Some good news, from the American Liver Foundation: liver problems can often be halted6 in the early stages. Cutting down on alcohol is a must, and losing weight never hurts, either. And research shows that certain foods7 assist in maintaining liver health. Garlic, fish with Omega-3 acids, broccoli, tea, and coffee are all positives. On the negative side, people with fatty liver should avoid sugar, refined grains, meat, and salty, fried foods.
For those who rely on pain relievers, many doctors will caution against using too much acetaminophen (e.g., Tylenol). In larger doses, it has proven to be more stressful on the liver than others.
Above all, in losing weight, many people don’t realize that alcohol has a ton of calories. A few drinks can quickly total 500 or 700 calories or more. That’s a significant percentage of an average, 2,000-calorie diet. (We note, too, that alcohol doesn’t add any vitamins, minerals, or nutrients.)
The Bottom Line: Your Liver Will Appreciate Less Alcohol
It’s always good to drink less. Even people who drink moderately and regularly should be candid with their doctor about alcohol use. (The Yale researchers note that many people are shocked that their “moderate” alcohol use has resulted in liver problems.)
At Ria, we are dedicated to helping people reduce alcohol. People choose to drink less for all sorts of reasons: to help relationships, to set a good example for their children, to avoid loss of work. (And to help that liver.) Perhaps the best reason of all is to simply live a better life. Alcohol can cause so many complications, and 2020 has been a year already jam-packed with uncertainty, stress, and anxiety.
Prevention, Prevention, Prevention
But we also believe prevention can be the best solution. Yes, you have to want change; medication alone, such as naltrexone, won’t do the trick. But with our program—combining evidence-based monitoring, FDA-approved medications, and skilled, compassionate coaching—you can be in control again. Get in touch with us to find out how our program can help you get there.
And remember, liver transplants are possible, but organ donors can be in short supply. As a doctor said to us years ago, “You only have one liver. I imagine you’d like to keep it.”