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Nonalcoholic Fatty Liver Disease and Obesity Treatment

  • Katherine T. Brunner
  • Cameron J. Henneberg
  • Robert M. Wilechansky
  • Michelle T. LongEmail author
Obesity Treatment (CM Apovian, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Obesity Treatment

Abstract

Purpose of Review

Nonalcoholic fatty liver disease (NAFLD), the most prevalent cause of chronic liver disease worldwide, is strongly associated with obesity and insulin resistance.

Recent Findings

Significant weight loss can improve NAFLD and nonalcoholic steatohepatitis (NASH). Diet and exercise that result in a sustained body weight reduction of 7–10% can improve liver fat content, NASH, and fibrosis. Vitamin E can be considered in patients with biopsy-proven NASH without diabetes, though caution must be used in those with prostate cancer. Pioglitazone improves liver histology, including fibrosis, and can be considered in patients with or without diabetes. Glucagon-like peptide-1 (GLP-1) antagonists may be beneficial in NASH, but more studies are needed before they can be recommended. Bariatric surgery, with resultant weight loss, can result in improvement in liver fat and inflammation.

Summary

NAFLD treatment includes diet and exercise with a target 7–10% weight reduction. Treatment goals include improvements in liver fat content, liver inflammation, and fibrosis.

Keywords

Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Obesity Diabetes Body mass index Magnetic resonance elastography NAFLD activity score Intrahepatic triglycerides Bariatric surgery 

Abbreviations

NAFLD

Nonalcoholic fatty liver disease

NASH

Nonalcoholic steatohepatitis

GLP-1

Glucagon-like peptide-1

BMI

Body mass index

MRI

Magnetic resonance imaging

CT

Computed tomography

MRS

Magnetic resonance spectroscopy

MRE

Magnetic resonance elastography

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

GGT

Gamma-glutamyltransferase

NAS

NAFLD activity score

PUFA

Polyunsaturated fatty acids

IHTG

Intrahepatic triglycerides

HIIT

High-intensity interval training

SG

Sleeve gastrectomy

RYGB

Roux-en-Y gastric bypass

AGB

Adjustable gastric banding

Notes

Compliance with Ethical Standards

Conflict of Interest

Katherine T. Brunner declares that she has no conflict of interest.

Cameron J. Henneberg declares that he has no conflict of interest.

Robert M. Wilechansky declares that he has no conflict of interest.

Michelle T. Long has received research funding from Echosens Corporation.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Katherine T. Brunner
    • 1
  • Cameron J. Henneberg
    • 2
  • Robert M. Wilechansky
    • 3
  • Michelle T. Long
    • 1
    Email author
  1. 1.Section of Gastroenterology, Boston Medical CenterBoston University School of MedicineBostonUSA
  2. 2.Boston University School of MedicineBostonUSA
  3. 3.Evans Department of Medicine, Boston Medical CenterBoston University School of MedicineBostonUSA

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