What should you know about causes of NAFLD?

The liver normally handles fats and sugars from food. When the body becomes less responsive to insulin, more fat may be delivered to the liver or made there, while the liver may clear it less effectively. [Obesity](/conditions/obesity/) and [Type 2 Diabetes](/conditions/type-2-diabetes/) commonly travel with this metabolic pattern. Diet, activity, inherited tendency, sleep, and some medicines can also influence risk.

NAFLD is distinct from liver damage caused mainly by alcohol. Alcohol use can still affect liver health, so clinicians ask about drinking rather than assuming that a fatty liver has one cause. Fatty liver may cause no symptoms and can be found during blood tests or imaging. Fat accumulation does not by itself show how much inflammation or scarring is present.

A clinician may review weight history, blood sugar, cholesterol, medicines, alcohol intake, and other liver risks. A [Liver Function Test](/treatments/diagnostics-and-screening/liver-function-test/) can provide part of the picture, while an [Abdominal Ultrasound](/treatments/diagnostics-and-screening/abdominal-ultrasound/) may show fat in the liver. Results do not always match the amount of liver damage, so further assessment may be considered. Sustainable changes in food choices, movement, sleep, and alcohol intake can support liver health. [Nutrition Counselling](/treatments/lifestyle-and-wellness/nutrition-counselling/) or a [Weight Management Programme](/treatments/lifestyle-and-wellness/weight-management-programme/) can help create an individual plan.

Arrange a review if fatty liver appears on a scan, liver blood tests are abnormal, or you have diabetes, obesity, or several metabolic risk factors. Seek prompt help for yellowing of the skin or eyes, vomiting blood, black stools, new confusion, severe abdominal swelling, or rapidly worsening illness. These symptoms can have causes beyond fatty liver and need timely assessment.

What may be contributing to fat in my liver? Do I need blood tests, an ultrasound, or assessment for scarring? Which food and activity changes are realistic for me? How should diabetes, weight, cholesterol, or alcohol be addressed together?