To treat fatty liver disease, the primary approach involves lifestyle changes, as there are currently no FDA-approved medications specifically for nonalcoholic fatty liver disease (NAFLD). Key treatment strategies include:

Lifestyle Changes

• Weight loss: Losing weight through a combination of a healthy diet and regular exercise is the most effective way to reduce liver fat, inflammation, and fibrosis. Even a 3-5% weight loss can reduce fat in the liver, while 7-10% weight loss may improve inflammation and scarring

• Healthy diet: Eating a balanced diet low in salt, sugar, and unhealthy fats, and rich in fruits, vegetables, and whole grains helps manage fatty liver. The Mediterranean diet is often recommended

• Regular exercise: Physical activity helps reduce liver fat and improves overall metabolic health

• Avoid alcohol: For alcoholic fatty liver disease, stopping alcohol consumption is critical. For NAFLD and metabolic dysfunction-associated steatotic liver disease (MASLD), limiting or avoiding alcohol is also advised

• Manage underlying conditions: Controlling diabetes, high cholesterol, high blood pressure, and metabolic dysfunction is important to prevent progression

Medical and Other Interventions

• Medications: No medications are currently approved specifically for NAFLD. Some diabetes medications (like metformin and GLP-1 agonists) and vitamin E are being studied but are not conclusively effective yet

• Bariatric surgery: For severe obesity with NAFLD, bariatric surgery (such as laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) may significantly improve liver health by reducing weight, oxidative stress, and inflammation

• Vaccinations: Getting vaccinated against hepatitis A and B, flu, and pneumococcal disease is recommended to reduce risk of liver complications

Monitoring and Specialist Care

• Regular follow-up with healthcare providers is important, especially if there is progression to nonalcoholic steatohepatitis (NASH) or cirrhosis. Liver specialists may be involved for advanced cases

In summary, treatment focuses on sustained weight loss through diet and exercise, avoiding alcohol, managing metabolic conditions, and, in some cases, surgical interventions. Medications are still under investigation and not yet standard therapy