Fatty Liver Disease: Killer Most People Don't Know About

Patty Vila knows too well the deadly threat that non-alcoholic fatty liver disease poses: She lost her father to it. But she was still shocked to learn recently that she also has an early form of the disease.

“I felt sick one day and I went to the emergency room and I was referred to a gastroenterologist. Two weeks later, they called me with the results and told me I had fatty liver disease too. I couldn’t believe it,” Vila recalls.

But Vila, who is 47, is lucky. Unlike most people, she was diagnosed with the disease early enough to take steps to fight it, says Dr. Eugene Schiff, one of the nation’s foremost liver disease specialists.

“I would say that two-thirds of people who have this condition are unaware of it. Most people don’t feel sick so by the time they are diagnosed with it they are usually in big trouble,” says Schiff, a professor at the University of Miami Miller School of Medicine and director of the Schiff Liver Center.

There are two types of this form of liver disease. Non-alcoholic fatty liver disease, or NAFLD, is a buildup of extra fat cells in the liver. This is the form that Vila has, along with an estimated 10 percent of children and at least 20 percent of Americans have fatty livers, which is the basis of NAFLD.

Having fatty liver disease itself doesn’t necessarily damage it, but in 10-20 percent of these cases (Schiff  puts it at 25 percent), the fat infiltrates the liver, which leads to a progressive type of fatty liver disease called nonalcoholic steatohepatitis, or NASH.

Studies show that 2-3 percent of American adults, or at least five million people, have this more progressive form of the disease. This is also the form of the disease that killed Vila’s father.

NASH causes cirrhosis, an ailment traditionally associated with alcoholics. Although NASH occurs in non-drinkers, the disease process is the same.

“NASH can eat away at the liver, and you won’t even be aware that you have it. It destroys the liver and is also linked to liver cancer as well,” says Schiff.  

Obesity is the major cause of nonalcoholic fatty liver disease, and its epidemic rate among adults and children is what is fueling the steeply rising numbers, says Schiff.

“Up until two years ago, the focus was clearly on hepatitis C because that disease was the most common reason for liver transplantation. But with today’s treatments, the cure rate for hepatitis C is now over 95 percent. So now the focus is on NASH,” says Schiff.

But obesity is not the only cause. Obesity increases the likelihood of metabolic syndrome, a deadly combination of conditions that can include diabetes, high cholesterol, and high triglycerides.

“Of the studies I’ve done in what causes NASH, I would say that the driving force is diabetes,” says Schiff.

At this point, there is no effective treatment for NASH and the only cure is a liver transplant. Unfortunately, the number of available livers outstrips the supply. This is what happened to Vila’s father, who died at the age of 71, while on the waiting list for a new liver.

The liver is the body’s only organ that can regenerate. As a result, there is hope for survival, if the disease is caught early, as in Vila’s case.

Like her father, Vila was never overweight so genetics likely played a role. But now, says Vila, “I watch my diet and I don’t drink alcohol or eat fried foods. I exercise every day and take care of myself, and I know that by doing these things, hopefully my liver will regenerate.”

Here are strategies that Schiff  and other experts say can prevent fatty liver disease:

• Lose weight. Shedding of 10 percent of your body weight over a year can really help.
• Cut out candy, pies, cakes, and other sweets containing sugar.
• Eliminate fried foods.
• Cut out foods containing high fructose corn syrup, which some experts believe may be fueling the fatty liver disease epidemic because it converts more quickly to fat.
•  Exercise.
• Take vitamin E daily. Studies on Vitamin E’s effects on the liver have been mixed, but it may be helpful.