Non-Alcoholic Fatty Liver Treatment - Viral Hepatitis and Liver Disease
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Viral Hepatitis and Liver Disease

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Non-Alcoholic Fatty Liver Treatment

for Health Care Providers

Treatment - Non-Alcoholic Fatty Liver

How can we treat non-alcoholic fatty liver?

  • 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.
  • 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 NAFL pharmacotherapy is currently licensed.

References

The Diagnosis and Management of Non-Alcoholic Fatty Liver DiseaseLink will take you outside the VA website. VA is not responsible for the content of the linked site.
Practice Guidance from the American Association for the Study of Liver Diseases; Hepatology, 2018