"Fatty Liver" on Your Ultrasound or Blood Test: What It Means and What Helps

Many women first hear “fatty liver” after an ultrasound for something else, or a routine blood test with slightly high liver enzymes. The condition, now often called metabolic dysfunction-associated steatotic liver disease (MASLD), means extra fat has built up in the liver, and not because of heavy drinking.¹

Two forms

• Fat without much inflammation. This form usually doesn’t progress to liver damage.¹
• Fat with inflammation and damage (called MASH, formerly NASH). This can lead to scarring (fibrosis), then cirrhosis, which can lead to liver cancer.¹

It’s usually silent. If there are symptoms, they’re tiredness or discomfort in the upper right belly.²

Who’s more likely to have it

Risk rises with overweight, insulin resistance or type 2 diabetes, high triglycerides or unhealthy cholesterol, and metabolic syndrome.² The more of these you have, the higher the chance of the inflamed form.²

What helps

• Gradual weight loss. Losing 3% to 5% of body weight can reduce liver fat. Losing 7% to 10% may be needed to reduce inflammation and scarring.³ For a 180-pound woman, 5% is 9 pounds.
• Physical activity helps even without weight loss.³
• Go slowly. Rapid weight loss and poor nutrition can make liver disease worse.³
• Losing weight can move the inflamed form back toward the milder form.²

A prescription option for some

Resmetirom is approved, along with diet and exercise, for adults with the inflamed form (MASH) and moderate to advanced scarring, but not cirrhosis.⁴ It received accelerated approval, which means its benefit is still being confirmed.⁴ Ask your clinician whether testing for scarring would show if you’re a candidate.

Skip the “liver detox”

Talk with your clinician before taking supplements for your liver, since some herbal remedies can damage the liver.³ Our article on milk thistle and liver detox supplements covers the evidence.

Questions to ask

1. Do I have the mild or inflamed form, and how will we know?
2. Should I have a test for liver scarring?
3. What weight and activity goals fit me?
4. How are my blood sugar, cholesterol and blood pressure?

Our guides to the PRIDE weight-loss trial and GLP-1 telehealth red flags cover weight-loss decisions.

Try: “My ultrasound said fatty liver. Do I need a scan or blood test for scarring, and how much weight should I aim to lose?”

Bloated by Dinner includes a Belly Clock log and a Test-It list with a visit script. Use them to track meals, activity and test results over the next few months. See the book.