Yes! It’s really a thing.

Before America got fat, a damaged liver was contributed to drinking. If someone had “cirrhosis of the liver,” well, they were probably an alcoholic.

But now, doctors are monitoring the rise of fatty liver, or non-alcoholic fatty liver disease, NAFLD. This disease is where fat causes a cirrhotic liver.

“With fatty liver, it is fat in the liver, and it should not be here. Fat is very irritating, to the liver. That irritation can cause inflammation, and if you irritate something long enough, you get scarring,” says Dr. Zarema Singson of Gastroenterology Consultants of San Antonio. 

Scarring happens as the liver tries to repair itself, from whatever damage is inflicted on it. But, too much scarring, or fibrosis, leads to the end game of cirrhosis of the liver. 

The liver is among our vital organs, right behind the brain, heart, and lungs. It is the CEO of our metabolic functions, managing toxins that we ingest. It is our second largest organ, behind the skin, and is our largest internal organ. If the brain is our central command, the liver is the workhorse. 

“The liver does a lot of different things. It makes bile, to help with digestion. It processes a lot of what we take into our body, to get rid of toxic substances. It is helpful in making energy for us, it turns glucose into glycogen, it makes proteins and blood-clotting factors, so it does a lot of different things,” says Dr. Singson. 

“A lot of my patients will say: ‘Well, I’ve never had a drink in my whole life!’”

Today’s patients have modern risk factors, which include:

• Being overweight/obese
• High blood pressure
• Cholesterol
• Diabetes

Some patients, have all of those. Hispanics especially, are genetically predisposed, to fatty liver disease.

A most dangerous aspect of the ailment is that people don’t know, that there’s anything wrong.“Most patients do not have symptoms,” says Dr. Singson. Often, it is discovered through routine lab work, or when a patient undergoes testing for something else. 

The good news is that healthy livers regenerate. It is the only organ that can completely regrow itself. Because of this, damage done to a healthy liver can be reversed, if it is caught in the early stages. 

Losing weight helps.

John Hopkins Medicine states that: “… by losing weight, liver enzymes may normalize and liver inflammation may improve.” And that: “Studies show that losing 10 percent of your weight causes the liver enzymes to improve, which correlates with a reduction in the liver inflammation caused by the extra fat.”

“I tell a lot of my patients to focus on diet and exercise, but it is so hard to do,” says Singson.

So, liver disease comes from too much alcohol, too much fat, but also from Hepatitis B, and Hepatitis C. They are less common — but they can lead to cirrhosis.

Another danger, posed to the liver, comes from the pills we take. Ibuprofen and acetaminophen carry warning labels, regarding their toxicity. Remember: livers deal with toxins. That is why some doctors don’t take anything at all. 

“The liver processes a lot of what we take into our gut. So, that helps to get rid of the toxic substances … and that can be a lot of the medications. We do know with cholesterol medications, statins, there can be some chance of injury,” says Dr. Singson. 

Americans take a lot of prescribed medications, and there is concern about toxicity there. Check labels of vitamins and supplements, as the liver must metabolize those too. 

Food has a big impact. That’s why Gastroenterology Consultants of San Antonio employs a nutritionist, Sonia Rodriguez. 

“The best advice to support liver health would be to include a variety of foods in the diet that provide balance and structured eating throughout the day, to promote blood sugar and hormone regulation, along with regular exercise or activity.” 

While the FDA states that there is a ‘reasonable certainty of no harm’ when it comes to our food’s additives and preservatives, other nutritionists go further about how diet affects livers. 

Georgiana Gross, MPH, is a research nutritionist with UT Health San Antonio. She suggests choosing foods closest to their natural state.  “Food additives, such as preservatives, artificial dyes, pesticides, and other contaminants, may have a detrimental impact on general health. Educating the public on label reading is essential for those individuals with sensitivities, or for those desiring a diet somewhat free of artificial substances.” 

Gross says buying foods with fewer than four ingredients means avoiding those additives and preservatives, found further down on ingredients lists, and in processed foods. 

By Berit Mason