Treating NAFLD by Defeating Obesity: What Are the Best Options?

Nonalcoholic fatty liver disease (NAFLD) — the hepatic manifestation of metabolic syndrome — is an increasingly common cause of transplantation, hepatocellular carcinoma, and death. Prevalence rates for NAFLD vary, but a recent analysis of middle-aged individuals in the United States placed it at nearly 40%. The same study estimated that the rate of nonalcoholic steatohepatitis (NASH) in this population was 14%. If changes are not implemented, the incidence of NASH is projected to increase up to 56% in the next 10 years.

Obesity is the most common and well-documented risk factor for NAFLD, and as such, the best target for successfully treating it. This requires clinicians to recommend various weight loss interventions, each with varying evidence of success, and implement them before fatty liver disease has taken its toll on the patient's health.

Lifestyle Interventions and Implementation

Several studies have sought to determine whether diet and lifestyle interventions are beneficial in those with type 2 diabetes. Perhaps the most recognizable among these is the Look AHEAD Trialwhich reported that significant and long-term improvements in body weight, physical fitness and function, glucose control, quality of life, and healthcare costs were associated with intensive lifestyle intervention. There is a lack of consensus, though, on how aggressively interventions should be escalated, which can result in the delay of weight loss management.