for Health Care Providers
Treatment - Non-Alcoholic Fatty Liver
How can we treat non-alcoholic fatty liver disease?
- Intensive lifestyle intervention with ≥7% weight loss diminishes liver inflammation; ≥10% weight loss decreasing liver fibrosis. Motivational interviewing to engage patient to create their preferred plan, cognitive behavioral therapy, weight loss, diet, and exercise provide the most enduring benefit. For more on motivational interviewing for NAFLD, please see our video and pocket guide for providers.
- As adjuncts to intensive lifestyle intervention,
- weight loss pharmacotherapy can achieve 3-9% weight loss
- bariatric surgery (up to 20-30% weight loss) may be considered if BMI≥40 kg/m2 or >35 with comorbidity (e.g., diabetes, HTN6)
- With elevated ALT (for >6 months) or increased fibrosis prediction score (e.g. FIB-4), non-alcoholic steatohepatitis is more frequent and merits hepatology/GI referral for consideration of FibroScan or liver biopsy.
- No NAFLD pharmacotherapy is currently licensed.
The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease
Practice Guidance from the American Association for the Study of Liver Diseases; Hepatology, 2018