A Top Doctor Reveals What Causes Fatty Liver and Why Menopause May Raise Your Risk

The liver is the largest internal organ in the body, and it’s got major jobs to do. The organ plays crucial roles in body processes such as optimizing metabolism, eliminating toxins, storing nutrients and regulating digestion. The problem? A condition called fatty liver that occurs when fat infiltrates the organ can cause its function to falter. But what causes fatty liver?

According to researchers reporting in the journal Hepatology , the prevalence of fatty liver disease has increased by more than 50% in the past three decades. Keep reading to discover why experts have deemed it a modern epidemic.

What is fatty liver?

“The term ‘fatty liver’ refers to the development of fat deposits in the liver, which impair the organ’s ability to perform key processes such as filtering out toxins, burning fat and keeping blood sugar in balance,” explains Fred Pescatore, MD .

Types of fatty liver include alcohol-related liver disease (ALD), which is caused by overconsumption of alcohol, and metabolic associated steatotic liver disease (MASLD), the most common type of fatty liver disease.

Formerly known as nonalcoholic fatty liver disease (NAFLD), MASLD was recently renamed by a panel of international experts reporting in the Journal of Hepatology.

“The new name reflects fatty liver’s close links to metabolic disorders such as metabolic syndrome,” Dr. Pescatore notes. Metabolic syndrome is a cluster of conditions that includes abdominal obesity, high blood sugar, high blood pressure, elevated triglycerides and low HDL cholesterol. It often goes hand-in-hand with fatty liver.

In fact, a study in the journal Cureus found metabolic syndrome occurred in 57% of fatty liver patients. That’s cause for concern, since excess fat in the liver triggers damaging inflammation that scars the organ and can lead to liver failure over time.

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What causes fatty liver?

Findings in the journal BMC Endocrinology reveal fatty liver can have a genetic component. And as Dr. Pescatore points out, “dips in estrogen that occur due to menopause can also lead to fatty liver, since estrogen helps the organ burn fat.”

Indeed, a Harvard University study determined that menopause more than doubled women’s odds of a fatty liver diagnosis. But lifestyle factors also play a major role in hampering liver function. They include:

1. Insulin resistance

The hormone insulin shunts glucose into cells so it can be burned for energy. “But when insulin resistance occurs, cells don’t heed insulin’s signals,” Dr. Pescatore notes. The result: Blood sugar climbs and gets stored in the body — including liver cells — as fat.

And when insulin resistance progresses to type 2 diabetes, risk of fatty liver escalates. According to a report in the journal Diabetes Spectrum , the condition is found in more than 70% of type 2 diabetes patients.

2. Excess belly fat can cause fatty liver

Fatty acids released from excess abdominal fat can flood the liver to encourage fat deposits in the organ. Plus, a study in the journal BMJ Open Diabetes and Research & Care determined that extra fat around the waistline significantly increased insulin resistance risk.

And as authors of a World Journal of Gastroeneterology study point out, inflammation produced by deep belly fat can trigger and worsen fatty liver disease. (Maintaining a healthy weight can help curb this risk.)

3. Imbalances in cholesterol and triglycerides

“The liver removes fats called triglycerides from the bloodstream, while HDL cholesterol helps clear fat from the organ,” explains Dr. Pescatore. So increases in triglycerides and shortfalls in HDL can deliver a one-two punch to the liver that causes it to clog with fat.

So it’s no surprise that a study in the journal Lipids in Health and Disease estimates the combination of high triglycerides and low HDL can increase fatty liver odds by as much as 820%.

4. Lack of physical activity

During exercise, your body burns fat for energy, including fat stored in the liver. Plus, staying active protects against other fatty liver causes such as insulin resistance, high triglycerides and obesity.

“But if you don’t exercise on a regular basis, you won’t get those benefits,” warns Dr. Pescatore. That’s why a Journal of Hepatology study found folks who skimped on physical activity were significantly more likely to develop fatty liver than those who exercised for at least 10 minutes of exercise five times per week.

Need another reason to stroll around the block ? Exercise aids weight loss, which can help reduce that troublemaking abdominal fat we mentioned above.

5. Modern-day diets can cause fatty liver

Sure, you know that fruits and vegetables are cornerstones of a healthy diet. But the processed foods that dominate most Americans’ diets are the root cause of nearly every condition associated with fatty liver, according to Dr. Pescatore.

“They’ve been shown over and over to increase risks of problems such as insulin resistance, high triglycerides and weight gain. That’s due to the high amounts of refined carbs, sugars and unhealthy fats they contain,” he says.

Indeed, a report in the journal Nutrients suggests frequent consumption of processed foods ups fatty liver risk by 42%.

Regardless of the cause, fatty liver can be reversed

If blood tests and a physical exam confirm a fatty liver diagnosis, don’t panic. The good news is that fatty liver can be reversed, which will improve your total-body health. It typically takes about a year to reverse the condition. Your best bet is covering the basics: follow a healthy diet, exercise more and lose weight. (Learn more about reversing fatty liver .)

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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .