GB News recently spoke with me about fatty liver disease, one of the most common liver conditions seen in clinical practice. The article's headline focuses on symptoms, but the most important message is almost the opposite: in the early stages there often are not any. That is why I want to explain how it develops, who should think about it, and how it is found.
What fatty liver disease is
Fatty liver disease is a build-up of fat in the liver cells. It can be linked to alcohol, but it also commonly occurs with metabolic syndrome, obesity and insulin resistance, as seen in type 2 diabetes. You may also hear the term MASLD, a newer name for the form associated with metabolic risk factors.
Why it is easy to miss
The liver is a forgiving organ. It can keep working normally while damage builds, which is a big reason fatty liver is overlooked or underdiagnosed. Over time, excess fat can cause inflammation and slowly lead to scarring, called fibrosis, which makes it harder for the liver to do its job. Early symptoms, when they appear at all, tend to be vague, and routine blood tests may not show a problem until the disease has progressed.
Who is at higher risk
- type 2 diabetes or prediabetes,
- insulin resistance,
- high cholesterol or triglycerides.
It can also affect people at a normal body weight, particularly those with a genetic predisposition, as well as people with hepatitis or HIV. In other words, you cannot rule it out by looking at the scale.
Symptoms to take seriously
The most common early complaints are fatigue, low energy, or discomfort in the upper right part of the abdomen. These are not specific to the liver, so they are a reason to get checked rather than a diagnosis.
More advanced disease can cause jaundice (yellowing of the skin or eyes), abdominal swelling, easy bruising, confusion, severe fatigue, vomiting blood, or black stools. These can signal significant scarring and need urgent medical attention.
How it is found
Imaging often detects fatty liver before blood tests or symptoms do. If you are concerned about your risk, ask your clinician about screening with blood work, an ultrasound, or a FibroScan, a non-invasive test that estimates liver fat and stiffness. The right test depends on your risk factors and history.
It can be preventable, and sometimes reversible
The encouraging part is that fatty liver is preventable and, in some cases, reversible when it is found early. The steps overlap with good metabolic health in general:
- Move regularly. Exercise can improve liver health.
- Cut back on processed and sugary foods. Build meals around vegetables, protein, fiber and unsaturated fats.
- Manage diabetes and cholesterol. Keeping them well controlled helps the liver too.
- Aim for gradual weight loss if you carry excess weight. According to the article, losing five to 10 percent of body weight has been shown to reduce fat inside the liver, and several weight loss medications have shown benefits in clinical studies. Whether medication is appropriate is an individual decision to make with your clinician.
- Be thoughtful about alcohol. Ask your clinician what is safe for you.
What to bring up at your next visit
It helps to tell your clinician about your family history of liver or metabolic disease, how much alcohol you drink, and any medications or supplements you take, since some of these can affect the liver. Ask whether your most recent blood work included liver tests, and what the results mean for you. A single normal result does not always rule out fatty liver, so the full picture matters.
If you have diabetes, prediabetes, or high cholesterol and have never been asked about your liver, it is a reasonable question to bring to your next visit. I look at the liver as part of a full metabolic evaluation in my practice.
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Medical disclaimer: This article is for general education only. It is not medical advice and does not create a doctor-patient relationship. Fatty liver disease has many causes, and testing and treatment depend on your individual situation. Talk with your own healthcare provider before starting, stopping, or changing any medication or testing. If you are having a medical emergency, call 911. This article is not sponsored and does not endorse any specific product.
Sources
- GB News. "Fatty liver disease symptoms in the bathroom that mean the condition has progressed, according to a doctor." Last updated July 16, 2026. https://www.gbnews.com/health/fatty-liver-disease-symptoms-stool-mood-skin-doctor
- National Institute of Diabetes and Digestive and Kidney Diseases. "Nonalcoholic Fatty Liver Disease (NAFLD) & NASH." https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash