Lifestyle changes are the main approach for managing fatty liver disease. These include eating a healthy diet, increasing physical activity and losing weight. Experts recommend getting at least 150 minutes of moderate exercise each week. Even a small amount of weight loss—as little as 5%—can lead to fatty liver improvement. But weight loss is difficult to achieve and maintain. Some research shows that people with NAFLD may have more trouble losing weight than others.

Extensive research is underway to develop medications to treat NAFLD and NASH. Fat and glucose metabolism and the development of fibrosis are complex, and scientists are taking a variety of approaches to manage fatty liver disease, targeting different steps in the process.

But progress has been slow. Several experimental drugs that produced favorable changes in biomarkers such as ALT, blood fats and glucose levels in early studies did not significantly improve fibrosis in larger clinical trials. Many experts expect that a combination approach will be needed to successfully manage NAFLD and NASH.