What are the current management options for nonalcoholic fatty liver disease?

Managing nonalcoholic fatty liver disease (NAFLD), now often called metabolic dysfunction-associated steatotic liver disease (MASLD), primarily relies on changing daily habits. Doctors recommend lifestyle modifications that lead to weight loss as the most effective treatment available today ⁶. Because this condition is strongly linked to obesity and diabetes, addressing these underlying issues is essential for success ⁶.

What the research says

Research shows that exercise training is a powerful tool for reducing liver fat and improving blood sugar control. A meta-analysis of 38 studies found that high-intensity interval training was likely the most effective type of exercise for lowering intrahepatic lipids ⁴. Other forms like aerobic training and combined aerobic and resistance training also showed benefits ⁴.

Diet plays a critical role as well. Ultra-processed foods are linked to obesity and metabolic disease, which drive the development of NAFLD. Reducing consumption of these foods can improve diet quality and help address the root causes of the condition ¹.

While lifestyle changes are the foundation, many pharmacological approaches have been explored. These include antidiabetic drugs and agents targeting specific liver pathways ⁵. However, despite promising results in studies, no medication has been approved for the treatment of NAFLD in the United States yet ⁶. Clinical trials are ongoing to study further pharmacologic treatment alternatives ⁶.

What to ask your doctor

• What specific lifestyle changes, such as diet or exercise, do you recommend for my liver health?
• Should I be screened for liver fibrosis given my diabetes or obesity?
• Are there any new medications for fatty liver disease that might be available in clinical trials for me?
• How can I work with a multidisciplinary team to manage my weight and liver disease effectively?