Fatty Liver: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Fatty Liver?
A hepatologist, a doctor who treats liver disease, or a gastroenterologist, a doctor who treats the digestive system, usually cares for fatty liver. Your primary care doctor often starts the work-up with liver tests. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is fatty liver?
Fatty liver is now often called steatotic liver disease. It happens when too much fat builds up in your liver. It is normal to have some fat in liver cells, but too much can be a problem.
There are two main types. MASLD is not caused by heavy alcohol use. It used to be called nonalcoholic fatty liver disease. Alcohol-associated liver disease, or ALD, is caused by heavy alcohol use.
MASLD has two main forms. Simple fatty liver means fat with little or no inflammation or liver damage. It usually does not get bad enough to cause damage. MASH is when MASLD gets worse. It adds inflammation and liver damage, which can lead to fibrosis, or scarring.
Symptoms
Both MASLD and ALD usually have few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your belly.
With MASH, symptoms can include fatigue, unexplained weight loss and muscle weakness. Many people have no symptoms until they have severe liver damage.
Causes and who gets it
The cause of MASLD is unknown. It is more common in people who:
- Have type 2 diabetes or prediabetes.
- Have obesity.
- Are middle aged or older, although children can also get it.
- Have high cholesterol or triglycerides, which are types of fat in the blood.
- Have high blood pressure.
- Take certain medicines, such as corticosteroids and some cancer medicines.
- Have rapid weight loss or certain infections, such as hepatitis C.
MASLD is the most common long-term liver disease. ALD only happens in heavy drinkers. The risk is higher in people who drink heavily and are women, have obesity, or have certain gene changes. Scarring from MASH or ALD can sometimes lead to cirrhosis, which is severe liver scarring.
How doctors diagnose it
Because there are often no symptoms, fatty liver is not easy to find. A provider may suspect it if you have abnormal liver tests. To make a diagnosis, a provider may use:
- Your medical history, including alcohol use and the medicines you take.
- A physical exam, which can look for an enlarged liver or jaundice, a yellow color of the skin and eyes.
- Blood tests, including liver function tests.
- Imaging tests to check for fat in the liver and for fibrosis.
- In some cases, a biopsy, which takes a small piece of liver to confirm the diagnosis and check for damage.
Treatment
The first step in treating MASLD is usually weight loss. Losing weight can reduce fat in the liver, inflammation and fibrosis. A healthy diet that limits salt and sugar and regular exercise can help.
The FDA has approved two medicines for adults with MASH and moderate to advanced liver scarring. Rezdiffra (resmetirom) is used with diet and exercise in people without cirrhosis. It has warnings for drug-induced liver toxicity, meaning liver harm, and gallbladder side effects. Wegovy (semaglutide) is the other. It should not be taken by people with a personal or family history of medullary thyroid cancer.
The most important part of treating ALD is to stop drinking alcohol. Counseling, a recovery program, or medicines can help. If cirrhosis leads to liver failure, you may need a liver transplant.
Check with your provider before using supplements or herbal remedies, because some can damage the liver. Do not stop taking any medicine unless your provider tells you to.
When to see a doctor
See a doctor if you feel tired or have discomfort in the upper right belly. Also see one if your skin or the whites of your eyes turn yellow.
Call 911 or go to the emergency room if you vomit blood, have severe belly pain, or have a sudden change in mental state, such as being hard to wake up.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can review your risks, order blood tests and follow your health over time. They can also refer you to a liver specialist when needed.
Common questions
Can fatty liver go away?
Yes, fatty liver can improve with weight loss. Losing weight can reduce fat in the liver, inflammation and scarring. Regular exercise can also help you lose weight and reduce liver fat.
Is fatty liver caused by alcohol?
Sometimes. Heavy alcohol use causes alcohol-associated liver disease. The other main type, MASLD, is not caused by heavy alcohol use.
Does fatty liver cause symptoms?
Usually not. Both main types usually have few or no symptoms. If symptoms do occur, you may feel tired or have discomfort in the upper right belly.
Can fatty liver lead to cirrhosis?
Yes, in some people it can. The more serious form, MASH, can cause scarring that sometimes leads to cirrhosis or liver cancer. Simple fatty liver usually does not get bad enough to cause damage.
Is there a medicine for fatty liver?
Yes, for some adults. The FDA has approved Rezdiffra and Wegovy for MASH with moderate to advanced scarring. Weight loss and exercise remain the first step.
Sources
- MedlinePlus - Steatotic Liver Disease
- U.S. Food and Drug Administration - FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease
- U.S. Food and Drug Administration - FDA Approves Treatment for Serious Liver Disease Known as MASH
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
