Fatty Liver Disease

What Is Fatty Liver Disease?

Fatty liver disease is categorized into two primary types:

• Non-Alcoholic Fatty Liver Disease (NAFLD): Occurs in individuals who consume little to no alcohol. It is strongly associated with metabolic conditions like obesity, insulin resistance, and type 2 diabetes.
  

• Alcoholic Fatty Liver Disease (AFLD): Caused by heavy and prolonged alcohol consumption, leading to fat buildup and damage in liver cells.
  

NAFLD can further progress to a more severe form called Non-Alcoholic Steatohepatitis (NASH), characterized by liver inflammation and liver cell damage, which can escalate to cirrhosis or liver cancer if left untreated (Mayo Clinic).

Prevalence in the Philippines

In the Philippines, fatty liver disease is on the rise due to increasing rates of obesity, diabetes, and sedentary lifestyles. A report from the Philippine Society of Gastroenterology indicated that NAFLD now affects an estimated 10% to 20% of Filipino adults, mirroring rising trends globally.

Filipino dietary patterns—characterized by high rice consumption, processed foods, sugary beverages, and low vegetable intake—are major contributors. Furthermore, the traditional stigma around liver disease being only alcohol-related often leads to delayed diagnosis in non-drinkers.

Symptoms of Fatty Liver Disease

Fatty liver disease is often asymptomatic, particularly in its early stages. However, as liver damage progresses, individuals may experience:

• Persistent fatigue and weakness (HealthDirect)
  

• Mild to moderate pain or discomfort in the upper right abdomen (Cleveland Clinic)
  

• Unexplained weight loss

• Loss of appetite
  

• Nausea or vomiting
  

• Swelling in the legs (edema) and abdomen (ascites)
  

• Jaundice (yellowing of the skin and eyes) (HealthDirect)
  

• Confusion, difficulty concentrating, or memory issues
  

It's important to seek medical evaluation if any of these symptoms are present, especially for those with existing risk factors.

Causes and Risk Factors

Fatty liver disease is influenced by several factors:

• Obesity: Excessive fat accumulation in the body increases the risk (Cleveland Clinic).
  

• Type 2 Diabetes: Insulin resistance plays a significant role.
  

• High Blood Lipids: Elevated levels of cholesterol and triglycerides contribute to liver fat.
  

• Unhealthy Diet: Diets rich in sugar, refined carbohydrates, saturated fats, and processed foods are linked to NAFLD.
  

• Sedentary Lifestyle: Physical inactivity promotes metabolic dysfunction.
  

• Genetics: Certain genetic variants, such as the PNPLA3 gene mutation, increase susceptibility.
  

• Rapid Weight Loss: Severe dieting or bariatric surgery can paradoxically lead to fat accumulation in the liver.
  

• Alcohol Consumption: Heavy drinking is a direct cause of AFLD.
  

Diagnosis

Fatty liver disease diagnosis typically involves:

• Physical Examination: Assessing for signs like liver enlargement.
  

• Blood Tests: Liver function tests measuring ALT and AST enzymes.
  

• Imaging Tests: Abdominal ultrasound, CT scan, or MRI can detect liver fat.
  

• Fibroscan: A specialized ultrasound that measures liver stiffness.
  

• Liver Biopsy: In severe or uncertain cases, a small tissue sample may be taken for confirmation.
  

Timely diagnosis is essential, as early-stage fatty liver is reversible with proper management.

Treatment Options

There is currently no FDA-approved medication specifically for NAFLD or NASH. The mainstay of treatment involves lifestyle interventions:

Lifestyle Changes:

• Weight Loss: Gradual weight reduction of 5%–10% can significantly decrease liver fat (Mayo Clinic).
  

• Healthy Diet: Prioritize fruits, vegetables, whole grains, legumes, lean protein, and healthy fats. Avoid sugary drinks, refined carbs, and high-fructose corn syrup.
  

• Regular Physical Activity: Aim for 150–300 minutes of moderate aerobic exercise per week.
  

• Blood Sugar Management: Keeping diabetes under control reduces liver strain.
  

• Cholesterol Management: Statins may be prescribed if lipid abnormalities are present.
  

• Avoid Alcohol: Even small amounts can worsen liver inflammation.
  

Medical Treatments:

• Vitamin E supplementation: Some studies suggest benefits in non-diabetic NAFLD patients.
  

• Pioglitazone: May be considered for some diabetic patients with NASH.
  

However, all medication use must be closely monitored by a healthcare provider.

Prevention

Fatty liver disease is largely preventable. Strategies include:

• Maintain a healthy weight: Regular monitoring of BMI and waist circumference.
  

• Adopt a heart-healthy diet: Similar to the Mediterranean diet.
  

• Exercise consistently: Incorporate both cardio and resistance training.
  

• Avoid excessive alcohol: Stick to recommended limits or abstain.
  

• Control metabolic conditions: Regular screening and proactive management of diabetes, hypertension, and dyslipidemia.
  

Public health initiatives in the Philippines increasingly encourage wellness practices that can help curb the growing fatty liver epidemic.

Seeking Help in the Philippines

Several leading hospitals such as the Philippine General Hospital, The Medical City, and St. Luke’s Medical Center have hepatology units that specialize in liver diseases. Diagnostic services like fibroscans and specialized imaging are becoming more accessible.

For individuals seeking convenient healthcare support, telehealth services like andyou.ph offer professional medical advice, screening options, and support tailored to Filipino lifestyles.

If you experience persistent symptoms or belong to a high-risk group, early consultation with a healthcare provider is highly recommended.

Fatty liver disease is a growing but often overlooked health issue in the Philippines. Fortunately, early-stage fatty liver disease is reversible. Through education, lifestyle change, early screening, and sustained management, Filipinos can greatly reduce their risk of serious liver complications.

Investing in your liver health today means investing in your long-term vitality and well-being.