Hepatic steatosis, commonly referred to as fatty liver disease, has emerged as a significant public health concern worldwide.


Characterised by the accumulation of excess fat in liver cells, this condition encompasses a spectrum of liver disorders ranging from benign fatty liver to more severe forms associated with inflammation, fibrosis, and cirrhosis.


Nonalcoholic fatty liver disease (NAFLD) now represents the leading cause of chronic liver disease globally, affecting individuals of all ages and demographics.


Understanding the underlying mechanisms, risk factors, and consequences of hepatic steatosis is crucial for effective prevention, diagnosis, and management of this increasingly prevalent condition.

Causes and Risk Factors

Hepatic steatosis, commonly known as fatty liver disease, occurs when excess fat accumulates in the liver cells. The primary causes of hepatic steatosis include obesity, insulin resistance, and metabolic syndrome.


Other contributing factors may include excessive alcohol consumption, certain medications, rapid weight loss, and genetic predisposition. Individuals with conditions such as type 2 diabetes, high cholesterol, or polycystic ovary syndrome (PCOS) are also at an increased risk of developing hepatic steatosis.



Hepatic steatosis often presents with no noticeable symptoms in its early stages, making it challenging to diagnose without medical evaluation. However, as the condition progresses, individuals may experience symptoms such as fatigue, weakness, abdominal discomfort, and an enlarged liver. 


In severe cases, hepatic steatosis can lead to complications such as liver inflammation (steatohepatitis), fibrosis, cirrhosis, and liver failure.



Diagnosing hepatic steatosis typically involves a combination of medical history assessment, physical examination, and diagnostic tests. Blood tests may reveal elevated liver enzymes, indicating liver inflammation or damage. 


Imaging studies such as ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can visualize the presence of fat in the liver. A liver biopsy is occasionally required to confirm the diagnosis and assess the extent of liver damage.



The treatment approach for hepatic steatosis aims to address underlying causes, manage symptoms, and prevent disease progression. Lifestyle modifications are often recommended as the first line of treatment and may include:

  1. Weight Loss: Achieving and maintaining a healthy weight through diet and exercise can help reduce fat accumulation in the liver and improve liver function.
  2. Healthy Diet: Adopting a balanced diet low in saturated fats, sugars, and processed foods while high in fruits, vegetables, and whole grains can support liver health and reduce inflammation.
  3. Regular Exercise: Engaging in regular physical activity can help improve insulin sensitivity, promote weight loss, and reduce liver fat accumulation.
  4. Limit Alcohol Consumption: For individuals with alcoholic fatty liver disease, abstaining from alcohol is crucial to prevent further liver damage.


Since hepatic steatosis makes a liver stiff, this can make surgery in the area (e.g. cholecystectomy for gallstones) more challenging. In such a scenario, low calorie diets or meal replacement shakes can be used to temporarily rid the liver of fat stores, shrink the liver and facilitate safe surgery.


In addition to lifestyle modifications, medications may be prescribed to manage underlying conditions such as diabetes, high cholesterol, or metabolic syndrome. In cases of nonalcoholic steatohepatitis (NASH) with advanced liver fibrosis or cirrhosis, specialised treatments may be necessary, including pharmacotherapy, weight loss surgery, or liver transplantation.

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