Fatty Liver Disease: Causes, Symptoms and Treatment (2025)

Fatty Liver: What It Is, Why It Matters, and How to Take Control

  • Jul 28, 2025 (Last updated: Jul 28, 2025 )
  • 10 Minutes Read
  • Authored By: Dr. Leonard Leng
  • Reversing and Managing Fatty Liver, Foods and Drinks for Liver Health, Stages and Symptoms of Liver Disease

What Is Fatty Liver Disease?

Fatty liver disease (FLD) occurs when excess fat accumulates in liver cells, potentially leading to inflammation, scarring, and impaired liver function. While the early stages may not cause symptoms, continued fat buildup can progress to fibrosis, cirrhosis, liver failure, or even liver cancer. Early detection and management of risk factors are crucial in preventing severe complications.

Fatty liver illustration showing fat buildup and liver cell damage from steatohepatitis.

What Causes Fatty Liver?

Fatty liver disease falls under the broader category of steatotic liver disease (SLD), which includes metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD).

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

MASLD is associated with obesity, insulin resistance, type 2 diabetes, high cholesterol, and high blood pressure, which collectively increase the risk of liver fat accumulation. A sedentary lifestyle and poor dietary habits, such as consuming excessive refined sugars and unhealthy fats, further contribute to fat buildup in the liver.

In Singapore, it is estimated that up to 40% of the population have MASLD.

Alcohol-Associated Liver Disease (ALD)

ALD is caused by excessive alcohol consumption, which impairs liver metabolism, leading to fat accumulation, inflammation, and liver cell damage.

Other contributing factors can include:

What Are the Symptoms of Fatty Liver?

Fatty liver disease is often asymptomatic in its early stages, meaning many individuals are unaware of the condition. However, some may experience:

  • Fatigue
  • Discomfort or pain in the upper right abdomen
  • Unexplained weight loss
  • Mild jaundice (in advanced cases)

As the disease progresses to steatohepatitis (a more severe stage of SLD) or cirrhosis, more severe symptoms may develop, including swelling in the legs (edema), confusion, and fluid buildup in the abdomen (ascites). Additionally, fatty liver disease is closely linked to cardiovascular disease, increasing the risk of high blood pressure, heart disease, and stroke.

Man holding right side in pain, suggesting liver discomfort from possible fatty liver.

Grades of Fatty Liver

Fatty liver can be classified into three grades depending on the percentage of liver cells containing fat:

Grade Description
Grade 1 (Mild Fatty Liver)
  • Fat accumulation in 5-33% of liver cells.
  • No significant inflammation or damage, usually asymptomatic.
  • Often detected incidentally during health screenings.
  • Reversible with lifestyle changes.
Grade 2 (Moderate Fatty Liver)
  • Fat accumulation in 34-66% of liver cells.
  • Mild inflammation may be present.
  • Some individuals experience fatigue or discomfort in the upper right abdomen.
  • Requires dietary changes and exercise to prevent progression.
Grade 3 (Severe Fatty Liver)
  • Fat accumulation in more than 66% of liver cells.
  • Higher risk of inflammation, fibrosis, and disease progression.
  • May lead to steatohepatitis, increasing the risk of cirrhosis if untreated.

Stages of Fatty Liver Disease

While the grades of fatty liver indicate the amount of fat accumulation in liver cells, the stages of fatty liver disease reflect the extent of liver damage and progression towards more severe conditions.

1. Simple Steatosis (Fatty Liver, No Inflammation)

  • Fat is present in liver cells but no significant inflammation or damage.
  • This stage is usually reversible with lifestyle modifications.

2. Steatohepatitis (Alcoholic or Non-Alcoholic)

  • Fat accumulation with inflammation and liver cell damage (ballooning degeneration).
  • Increased risk of liver scarring (fibrosis) and disease progression.
  • Requires medical management to prevent further damage.

3. Fibrosis (Liver Scarring)

  • Inflammation leads to scar tissue formation, reducing liver function over time.
  • Still potentially reversible if treated early.

4. Cirrhosis (Severe Liver Scarring)

  • Extensive scarring disrupts normal liver function.
  • Irreversible but can be managed to slow progression.
  • Increases the risk of liver failure and liver cancer.

How Is Fatty Liver Diagnosed?

Fatty liver is often detected during routine health screenings, as it may not cause noticeable symptoms in the early stages. Doctors use a combination of tests to confirm the condition and assess its severity:

  • Blood Tests – Liver function tests, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), help detect liver enzyme elevations, which may indicate liver inflammation.
  • Imaging Tests:
    • Ultrasound – A non-invasive scan that detects fat accumulation in the liver and helps determine the grade of fatty liver.
    • Liver Elastography – Provides detailed imaging to detect fat distribution and potential complications.
    • MRI or CT Scan – Provides more detailed imaging of the liver.
  • Liver Biopsy – In cases where inflammation, fibrosis, or cirrhosis is suspected, a small tissue sample is extracted for microscopic examination to assess the stage of liver damage.
Liver ultrasound scan performed to assess fatty liver, health status, and possible fibrosis.

Fatty Liver Disease Treatment

There is no specific medication approved to treat fatty liver disease, but management focuses on addressing the underlying causes and preventing disease progression. Treatment strategies vary based on whether the condition is due to MASLD or ALD.

Treatment Approach Description
Exercise and Weight Loss Engaging in regular exercise can help reduce liver fat, improve insulin sensitivity, and slow disease progression.
Dietary Changes A diet rich in fruits, vegetables, whole grains, and healthy fats helps lower liver fat, while avoiding sugar, refined carbohydrates, and saturated fats reduces inflammation. Complete alcohol cessation is essential for ALD, and limiting alcohol intake may benefit those with MASLD.
GLP‑1 Receptor Agonists Medications such as semaglutide and tirzepatide may help reduce liver fat, improve liver inflammation, and support weight loss in individuals with MASLD or advanced MASLD. These are typically used in patients with obesity or type 2 diabetes and should be prescribed by a doctor.
Managing Underlying Conditions Controlling diabetes, high cholesterol, and hypertension can prevent fatty liver from progressing to steatohepatitis, fibrosis, or cirrhosis.
Liver Transplant For end-stage liver disease due to cirrhosis, a liver transplant may be necessary when liver function is severely impaired.

Fatty Liver Testing in Singapore

At ATA Medical, we provide various liver assessments and personalised treatment strategies to help monitor and maintain your liver health, with the prices as follows:

Treatment Price*
Consultation From $38.15
Blood Tests
Liver Function Test A
Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT 		$30.52
Liver Function Test B
Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio) 		$34.88
Liver Function Test C
Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio, LDH, Hepatitis Bs Antigen & Antibody, Hepatitis A Total IgG, Alpha Fetoprotein [AFP] 		$91.56
Imaging Tests
Ultrasound Liver $150.42
Ultrasound Liver Elastography $196.20
MR Liver Elastography $566.80
MRI Abdomen (Kidney, Liver, Pancreas, Gallbladder & Spleen) $1471.50
Weight Loss Treatments
Appetite Suppressants From $200
Weight Loss Injections $422.92 / box**
*Prices are NETT and inclusive of GST.
**One box contains 3 vials and each vial can last 6 days at maximum dose.

Conclusion

Fatty liver disease is often silent in its early stages, but if left unaddressed, it can lead to serious complications, including cirrhosis, liver failure, and even liver cancer. Fortunately, with early detection and the right lifestyle changes, fatty liver is preventable and, in some cases, reversible. Simple steps like maintaining a healthy diet, engaging in regular exercise, and managing underlying health conditions can make a significant difference in protecting your liver.

If you are at risk or suspect you may have fatty liver, schedule a consultation with our doctors today to learn more about your liver health and steps for prevention and management.

Why Choose ATA Medical?

ATA Medical – One-Stop Health Screening Clinic With X-ray, CT Scan, Mammogram and Ultrasound scans.
ATA Medical – One-Stop Health Screening Clinic With X-ray, CT Scan, Mammogram and Ultrasound scans.
ATA Medical Orchard Clinic with Health Screening Nurses and Staff
Orchard Clinic
ATA Medical Tanjong Pagar Clinic with Health Screening Nurses and Staff
Tanjong Pagar Clinic
Patient having a health screening review with Dr Jana Lim of ATA Medical
Health Screening Review with Dr Jana Lim
Female patient undergoing ultrasound scan procedure at ATA Medical Clinic.
Mammograms & Ultrasound Scans with Female Staff
Female patient getting ready to undergo X-Ray procedure with a male staff assisting with the preparations.
One-Stop Clinic with X-Ray Facilities
Dr Leonard Leng of ATA Medical having a consultation session with a male patient.
Consultation About Men or Female Health With a Doctor of Your Choice

Making a Difference Together

At ATA Medical, we strive to make a meaningful impact on every patient's health. With over 120,000 patients served, we are dedicated to fostering trust and enhancing well-being across our community.

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Email Us at camden@atamed.sg for More Information.

Book Your Health Screening With Us at 88838892.

Frequently Asked Questions (FAQs)

The time required to reverse fatty liver depends on the severity of fat accumulation and adherence to lifestyle changes. In mild cases, reducing liver fat can take a few months with consistent weight loss, dietary improvements, and regular exercise. More advanced cases, such as those with inflammation or fibrosis, may take longer and require medical management to prevent progression. Consulting a doctor or specialist can help determine the most suitable treatment plan.
Carrot juice contains antioxidants, beta-carotene, and fibre, which support overall liver health, but there is no conclusive evidence that it directly reverses fatty liver disease. While it can be part of a balanced diet rich in fruits and vegetables, excessive intake may contribute to excess sugar consumption, which can be counterproductive. It is advisable to focus on a well-rounded diet rather than relying on a single food or beverage for liver health.
Grade 2 fatty liver indicates moderate fat accumulation (34-66% of liver cells) with potential mild inflammation, which increases the risk of progression to steatohepatitis or fibrosis if left unmanaged. Although it is not immediately life-threatening, lifestyle changes such as weight management, dietary adjustments, and exercise are vital to preventing further liver damage. Consulting a doctor for monitoring and a personalised treatment plan is recommended.
Sugarcane juice is high in natural sugars, which can contribute to fat buildup in the liver, especially in individuals with conditions like high blood sugar or excess abdominal fat. While it contains some antioxidants, its high glycaemic index may worsen fatty liver disease if consumed in excess. It is advisable to limit sugary beverages and opt for water or unsweetened drinks as healthier alternatives.
A diet for reducing fatty liver should emphasise whole, nutrient-dense foods that lower liver fat and improve overall health. Eating vegetables, fruits, whole grains, lean proteins, and healthy fats like olive oil and nuts supports liver function, while limiting added sugars, refined carbohydrates, trans fats, and alcohol helps prevent fat buildup. Maintaining a caloric deficit through portion control and balanced meals aids weight management, which is key to reversing fatty liver. For personalised dietary guidance, consulting a doctor or dietitian is recommended.
Fatty liver can often be reduced naturally through weight loss, regular exercise, and dietary improvements. Losing excess weight helps decrease liver fat, while aerobic exercise and resistance training improve insulin sensitivity and fat metabolism. A diet low in refined sugars, processed foods, and unhealthy fats, combined with adequate hydration and good sleep, further supports liver function. For those at risk of disease progression, consulting a doctor for monitoring and personalised guidance is advisable.
Fatty liver occurs when excess fat accumulates in liver cells due to non-alcoholic fatty liver disease (NAFLD), linked to obesity and metabolic conditions, or alcoholic fatty liver disease (AFLD), caused by excessive alcohol intake. While often symptomless, it can progress to liver inflammation (steatohepatitis), scarring (fibrosis or cirrhosis), and liver failure if left unmanaged. Addressing the underlying cause through lifestyle changes and medical evaluation is key to preventing complications.
Fatty liver can often be improved through weight loss, dietary changes, and regular exercise, though the extent of improvement depends on its severity. A nutrient-rich diet with whole grains, lean proteins, healthy fats, and fibre supports liver health, while limiting refined sugars, processed foods, and unhealthy fats helps prevent further fat buildup. Regular aerobic and resistance exercises enhance insulin sensitivity and fat metabolism. Managing underlying conditions like diabetes and high cholesterol is also crucial. Consulting a doctor can help determine the most suitable approach for your health.
Fatty liver disease occurs when excess fat builds up in liver cells due to non-alcoholic fatty liver disease (NAFLD) or alcoholic fatty liver disease (AFLD). NAFLD is linked to obesity, insulin resistance, type 2 diabetes, and high cholesterol, while AFLD results from chronic excessive alcohol consumption. Other factors include rapid weight loss, malnutrition, certain medications, viral hepatitis, and genetic predisposition. Managing these risks can help prevent progression to more severe liver conditions.
Many people with fatty liver disease can live a full life if the condition is managed well and does not progress to severe stages. Adopting a healthy diet, regular exercise, and weight management can help prevent further liver damage and maintain overall health. Routine medical check-ups and managing related conditions like diabetes and high cholesterol are also important. While fatty liver requires ongoing care, most individuals can lead normal, healthy lives with the right lifestyle adjustments.
Fatty liver disease is often asymptomatic in its early stages, but when symptoms do appear, fatigue, upper right abdominal discomfort, and unexplained weight loss are among the most common. In more advanced cases, jaundice, leg swelling (edema), and abdominal fluid buildup (ascites) may occur. Routine liver screenings, including blood tests and imaging, can help detect fatty liver before symptoms develop.
Fatty liver is called 脂肪肝 (Zhīfáng gān) in Chinese. It refers to the buildup of excess fat in liver cells, which can develop due to metabolic factors or excessive alcohol consumption. Treatment focuses on diet, exercise, and managing underlying conditions to prevent progression to more severe liver complications.
Eggs can be included in a balanced diet as they provide high-quality protein and essential nutrients. However, individuals with high cholesterol or insulin resistance may need to moderate their intake, especially of egg yolks. Boiled or poached eggs are healthier choices compared to fried eggs cooked in unhealthy oils. A balanced diet rich in vegetables, whole grains, and lean proteins is recommended for liver health. For personalised dietary advice, consulting a doctor or dietitian is advisable.
No drink can "clean" the liver, but staying hydrated and choosing liver-friendly beverages may support liver health. Water, green tea, coffee (in moderation), and herbal teas like dandelion or turmeric tea contain antioxidants that may help reduce inflammation. Fresh vegetable juices can provide beneficial nutrients, but high-sugar fruit juices and alcohol should be limited to avoid further liver damage. For more personalised dietary advice, it is best to consult a doctor or dietitian.
Fatty liver can often be reversed in its early stages through weight loss, dietary changes, and regular exercise, which help reduce liver fat and inflammation. However, if it progresses to non-alcoholic steatohepatitis (NASH) or alcoholic steatohepatitis (ASH), fibrosis, or cirrhosis, the damage may become irreversible. Consulting a doctor for assessment can help evaluate the severity of fatty liver and determine the best approach for management.
There is no single food that directly causes fatty liver, but excessive consumption of added sugars, refined carbohydrates, and saturated fats is strongly linked to fat accumulation in the liver. Sugary beverages, processed foods, and fried or fast foods can contribute to insulin resistance and metabolic dysfunction, increasing the risk of fatty liver disease. A balanced diet focusing on whole, nutrient-rich foods is key to prevention.
Liver health can often be improved by losing weight, adopting a balanced diet, exercising regularly, and managing conditions like diabetes and high cholesterol. Avoiding alcohol, processed foods, and excessive sugar helps reduce liver fat buildup, while staying hydrated, getting adequate sleep, and minimising toxin exposure further supports liver function. For those with advanced liver disease, regular medical monitoring and treatment may be necessary to prevent complications.
Individuals with fatty liver should limit sugary foods, refined carbohydrates, fried foods, processed meats, and alcohol, as these contribute to liver fat buildup and inflammation. High-sodium foods should also be reduced to prevent fluid retention and liver strain. Instead, a diet rich in vegetables, whole grains, lean proteins, and healthy fats is recommended to support liver health. For more personalised dietary advice, consulting a doctor or dietitian is advisable.
Stage 1 fatty liver, or simple steatosis, is the earliest stage of non-alcoholic fatty liver disease (NAFLD) or alcoholic fatty liver disease (AFLD), where fat accumulates in liver cells without significant inflammation or scarring. It is usually asymptomatic and reversible with lifestyle changes like weight management, a healthy diet, and regular exercise. However, if left unmanaged, it may progress to non-alcoholic steatohepatitis (NASH) or alcoholic steatohepatitis (ASH), fibrosis, and cirrhosis, increasing the risk of liver damage.
There is no scientifically proven way to "detox" the liver in three days, but hydration, a nutrient-rich diet, and avoiding alcohol, processed foods, and excessive sugar can support liver function. Drinking water, green tea, and herbal teas may aid metabolism, while eating leafy greens, cruciferous vegetables, and antioxidant-rich foods can help reduce oxidative stress. Long-term lifestyle changes, rather than short-term detoxes, are key to maintaining liver health.
There is no quick cure for fatty liver, but gradual weight loss, dietary improvements, and regular exercise are key to reducing liver fat. Losing excess weight helps lower fat accumulation and inflammation, while limiting alcohol, processed foods, and added sugars supports liver health. Increasing whole foods, healthy fats, and fibre is also beneficial. However, if fatty liver progresses to significant liver damage, such as fibrosis or cirrhosis, it becomes irreversible and requires medical management to prevent further complications.
Stage 1 liver failure, also known as compensated cirrhosis, occurs when the liver has sustained chronic damage but can still perform its essential functions. Symptoms are often mild or absent, though some individuals may experience fatigue, weakness, or mild fluid retention. Without intervention, it can progress to stage 2, or decompensated liver failure, where severe complications such as jaundice, ascites, and hepatic encephalopathy develop due to significant loss of liver function.
Fruits rich in antioxidants, fibre, and vitamins, such as berries, citrus fruits, apples, and grapes, can support liver health. Berries contain polyphenols that may help reduce liver inflammation, while citrus fruits provide vitamin C to aid detoxification. However, fruits high in natural sugars, like mangoes and bananas, should be eaten in moderation, especially for those with insulin resistance or metabolic conditions. For personalised dietary advice, consulting a doctor or dietitian is recommended.
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