Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) can be managed by lifestyle changes. Good nutrition, maintaining a healthy weight and regular exercise are important. In a retrospective analysis of obese middle-aged men (Hepatology, April 2015), researcher Sechang Oh and colleagues reported that moderate to vigorous physical activity had a dramatic effect. Those who engaged in ≥ 250 minutes a week of moderate to vigorous physical activity had the most improvement of NAFLD.
That is more than four hours of exercise weekly. This amount of regular physical activity seemed to improve liver health, regardless of weight loss. Other research shows similar benefits. When it came to liver health, aerobic activity (AKA cardio) resulted in greater improvement than resistance training.
Note: Exercising in short intervals, such as 10 minutes, several times daily, is as effective as exercising for larger stretches of time.
There are no FDA-approved treatments for NAFLD or its later stage, NASH. There are NASH products in the pipeline. Here are the compounds currently in mid to late phases of clinical trials:
- Ocaliva (obeticholic acid) This drug is is already FDA-approved for the treatment of primary biliary cholangitis (PBC)
Click here for more specific information about each drug in development for the treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).
In some cases, your doctor may prescribe the type 2 diabetes medication, Actos (pioglitazone), even if you don’t have diabetes. Vitamin E (800 IU daily) may be prescribed for certain patients.
If your cholesterol or blood glucose levels are elevated, medications to lower these may be prescribed. If NASH has progressed to cirrhosis, drugs may be prescribed to manage water retention or hepatic encephalopathy. If NASH progresses to complete liver failure or liver cancer, liver transplantation may be considered.
Here are some other recommendations for people with fatty liver disease:
- Avoid alcohol.
- Get vaccinated against hepatitis A (HAV) and hepatitis B (HBV) if you haven’t already been immunized.
- Take only medicines, herbs and dietary supplements that are medically prescribed.
- Be sure to follow medical advice for keeping diabetes and high cholesterol in check.
- See a liver specialist regularly, and get follow-up tests to monitor for signs of advanced liver disease.
Last Reviewed: May 2, 2019