Nonalcoholic Fatty Liver Disease and Obesity Treatment
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.
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.
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.
KeywordsNonalcoholic fatty liver disease Nonalcoholic steatohepatitis Obesity Diabetes Body mass index Magnetic resonance elastography NAFLD activity score Intrahepatic triglycerides Bariatric surgery
Nonalcoholic fatty liver disease
Body mass index
Magnetic resonance imaging
Magnetic resonance spectroscopy
Magnetic resonance elastography
NAFLD activity score
Polyunsaturated fatty acids
High-intensity interval training
Roux-en-Y gastric bypass
Adjustable gastric banding
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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