How does obesity lead to fatty liver? Scientific weight loss is the key to reversing it.

Fatty Liver

The liver is the main site of fat metabolism, and fatty liver is a disease characterized by abnormal liver fat metabolism. In normal individuals, total fat in the liver accounts for 5% of liver weight, containing phospholipids, triglycerides, fatty acids, cholesterol, and cholesterol esters. In patients with fatty liver, total fat can reach 40%–50%, mainly triglycerides and fatty acids. Normally, triglycerides in the liver bind to lipoproteins and are excreted as very low-density lipoprotein (VLDL). When there is an imbalance between triglyceride synthesis and VLDL excretion, fat accumulation occurs, leading to fatty liver.

Most patients with non-alcoholic fatty liver disease (NAFLD) are obese, and over 60% of obese patients have fatty liver. Studies have shown that fatty liver can appear in childhood, and there is a direct link between the degree of childhood obesity and the prevalence of fatty liver. Children with subcutaneous abdominal fat thickness >30 mm have a fatty liver prevalence of up to 44.4%. Therefore, fatty liver can be considered a progressive manifestation of obesity.

Obesity-induced fatty liver is mainly due to increased adipose tissue and increased release of free fatty acids. Obese patients often also have type 2 diabetes. These patients frequently exhibit hyperinsulinemia and peripheral insulin resistance, prompting peripheral fat mobilization and the transport of free fatty acids to the liver, causing liver damage. Hyperinsulinemia can also induce increased hepatic triglyceride synthesis and accumulation in the liver. Besides insulin factors, obese individuals also experience increased fat intake, increased peripheral adipose tissue mobilization, increased hepatic triglyceride synthesis, and relatively insufficient very low-density lipoprotein (VLDL) synthesis, leading to impaired fat excretion from the liver.

Patients with obesity, diabetes, and fatty liver should reduce their weight through a reasonable diet and exercise. However, sudden weight loss should be avoided, as rapid weight loss can increase peripheral tissue fat mobilization, leading to elevated free fatty acid levels and exacerbating fatty liver.

A reasonable diet is a crucial part of fatty liver treatment. The diet should be high in protein, with appropriate amounts of fat and carbohydrates, especially ensuring adequate protein intake. Otherwise, insufficient protein intake can lead to impaired VLDL formation and excretion.

Appropriately increasing physical activity is also important for the treatment of fatty liver. Reducing your weight to a healthy level within 5 months can help eliminate fatty liver.

Currently, there is no specific medication for fatty liver.