HEALTH AND WELLNESS
Liver disease
Fatty liver disease isn’t just caused by alcohol. What to know
Alexandra FrostUSA TODAY
Aug. 7, 2026, 5:00 a.m. ET
The liver just might be one of your hardest-working organs, producing proteins and filtering the blood, metabolizing nutrients and creating necessary bile for digestion. But sometimes the liver can develop abnormalities that can inhibit its function, such as fatty liver. You might think of alcohol as a potential cause, but this isn’t the only cause. The surprisingly common diagnosis has several culprits and the symptoms can be silent. Here’s what you need to know about this disease
What is fatty liver disease?
In simplest terms, fatty liver is a result of excess fat buildup in the liver. In America, recent research has found that around 40% of Americans have the disease, with the Hispanic population having the highest rate
“In the early stages, there are no obvious symptoms, no dramatic warning,” says Dr. Susan Kais, dual board-certified gastroenterologist and hepatologist at UC Health in Cincinnati. “The liver silently becomes overwhelmed while the body carries on.” Some of the first signs could be abnormalities in your liver tests
“Liver injury starts with inflammation, and if left untreated, it can progress to irreversible scarring known as cirrhosis of the liver,” Kais says
Main causes of fatty liver disease
While alcohol can be one of the causes of fatty liver, it’s important to remember that other conditions can also lead to the diagnosis. Obesity, type 2 diabetes, high cholesterol and family history can all be factors in metabolic dysfunction-associated steatotic liver disease (MASLD), which is the non-alcohol-related condition of the disease
“Insulin resistance and diabetes contribute to fatty liver in individuals who do not drink or who are not overweight,” explains Kais. “An individual can have insulin resistance without being obese, hence increasing the risk and likelihood of fat accumulating in the liver. Diabetes is one of the strongest risk factors for fat accumulating in the liver regardless of body weight.” Research has shown even just a single soda per day (or less) can contribute to MASLD
What to do about your fatty liver
Kais says one of the most important ways to manage the condition is to understand the root cause of the diagnosis. Things like weight management, watching your diet and limiting alcohol can all play important roles in managing the disease
“For patients with obesity, focusing on exercise and weight loss can make a meaningful difference,” she says. “If diabetes is a contributing factor, aggressive blood sugar control is essential. And if alcohol is involved, stopping drinking is critical.”
It’s important to remember that a fatty liver diagnosis can have a long-term impact on your health, even if the symptoms are minimal
“Fatty liver disease is often silent, but that does not mean it is harmless,” says Dr. Kais. “It can progress to liver scarring, known as cirrhosis, and by the time symptoms appear, significant damage may already be done. I always tell my patients: ‘You can live without your kidney, but you cannot live without your liver. Protect it at all costs.’”
