Fatty liver disease is a health condition in which fat builds up in the liver. This fat buildup can cause inflammation and, in severe cases, liver damage.
There are two main types of fatty liver disease: Alcohol-associated liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD). ALD results from heavy alcohol use over a long time, while MASLD is linked to metabolic conditions such as obesity and type 2 diabetes.
Both types of fatty liver disease can have similar symptoms that progress over time.
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If you’re in the early stages of fatty liver disease, fat has built up in your liver to the point that the fat makes up more than 5% of your liver’s weight yet there’s no evidence of inflammation or liver damage. This stage may be called simple fatty liver, hepatic steatosis, or metabolic dysfunction-associated steatotic liver disease (MASLD).
People in these stages usually have no noticeable symptoms. However, it is possible to have symptoms such as:
- Fatigue
- Weakness
- Overall feeling of being unwell
- Pain or discomfort in the upper right side of your abdomen, where the liver is located
- Hepatomegaly (enlarged liver)
As fatty liver disease progresses, the increasing buildup of fat begins to cause inflammation in the liver. This stage of the disease may be called metabolic dysfunction-associated steatohepatitis (MASH) or alcohol-associated hepatitis, depending on the cause.
Over time, inflammation can damage your liver and lead to fibrosis. Fibrosis occurs when your body begins to make scar tissue in the liver. This happens because inflammation damages liver cells, and making scar tissue is your liver’s way of trying to repair those cells.
Once fatty liver disease has progressed to MASH or alcohol-associated hepatitis, symptoms are more likely to occur. Still, many people do not have noticeable symptoms at this point. Along with possible early-stage symptoms like fatigue, other signs and symptoms of progressing fatty liver disease may include:
- Itchy skin
- Increased thirst
- Bloating
- Decreased appetite
- Loss of mental clarity
- Mood swings
- Edema (fluid buildup) in your lower legs
- Fever (in those with alcohol-associated hepatitis)
- Jaundice (yellowing of the eyes and skin)
Often, symptoms like these may indicate that fibrosis has progressed to cirrhosis (permanent scarring of the liver). In cirrhosis, scar tissue builds up to the point that it replaces healthy tissue and stops your liver from functioning as it should.
If fatty liver disease goes unmanaged, it may lead to cirrhosis. Ultimately, cirrhosis can progress to end-stage liver disease, or liver failure. Liver failure means your liver can no longer perform its functions in the body. People with liver failure typically need a liver transplant to survive.
Symptoms of cirrhosis and liver failure can include all the symptoms above, along with:
- Nausea with vomiting
- Weight loss
- Muscle cramps or weakness
- Muscle loss
- Easy bleeding or bruising
- Memory loss
- Sleep disorders
- Sexual dysfunction
- Ascites (fluid buildup in the abdomen)
Although fatty liver disease most commonly affects older adults, it also can affect children. As rates of obesity among children are rising, so are rates of fatty liver disease. Currently, up to 1 in 10 children ages 2-19 have MASLD.
Like adults, children with fatty liver disease may have no symptoms unless the condition has progressed to a more severe stage. Symptoms in children may be the same or they may differ slightly from those in adults. Along with fatigue and abdominal discomfort, as in adults, symptoms in children may include:
- Headaches
- Irritability
- Trouble concentrating
- Depression or anxiety
- Changes in skin color near the joints, on the back of the neck, or on the upper back
Fatty liver disease can be a serious condition with life-threatening complications. But with early diagnosis and management, you may be able to reverse the damage fatty liver disease causes. If you experience any of the following symptoms, contact a doctor:
If you have risk factors for fatty liver disease, such as obesity, type 2 diabetes, hepatitis C, or heavy alcohol use, talk to your doctor about screening and prevention.
Fatty liver disease results from a buildup of fat in your liver. In early and progressive stages, it doesn’t always cause symptoms. If you do have symptoms, they can include fatigue, weakness, and bloating. Without management, the condition can progress to liver failure. More severe fatty liver disease can cause symptoms like pain in your upper-right abdominal area, swelling, jaundice, weight loss, and nausea.
