Non-Alcoholic Fatty Liver Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Non-Alcoholic Fatty Liver Disease?
A hepatologist, a doctor who treats liver disease, leads care for this condition. Losing weight is the first step in treatment, and the FDA has approved two medicines for the more serious form. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Non-Alcoholic Fatty Liver Disease?
Non-Alcoholic Fatty Liver Disease means too much fat builds up in your liver. It is not caused by heavy alcohol use. Doctors now call it metabolic dysfunction-associated steatotic liver disease, or MASLD. It has two main forms. Simple fatty liver has fat but little or no inflammation (swelling) or liver damage. The other form, called NASH (nonalcoholic steatohepatitis), has fat plus inflammation and liver damage. This can lead to fibrosis, or scarring, of the liver. The scarring sometimes leads to cirrhosis, where the liver is scarred and cannot work well, or to liver cancer.
Symptoms
The disease usually has few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your belly. Because there are often no symptoms, it is not easy to find the disease.
Causes and who gets it
The cause is not known. The disease is more common in people who have type 2 diabetes or prediabetes, obesity, high cholesterol or triglycerides, or high blood pressure. Metabolic syndrome, a group of health problems tied to extra weight, also raises risk. Children can get it too, but it is more common in middle age or older.
How doctors diagnose it
Because there are often no symptoms, your doctor may suspect it if you have abnormal results on liver tests. Your doctor will ask about your alcohol use and any medicines you take. A physical exam checks your height and weight and looks for signs like an enlarged liver or jaundice, yellowing of the skin and eyes. Blood tests include liver function tests. Imaging tests can check for fat in the liver and for fibrosis, or scarring. In some cases a biopsy, a tiny piece of liver tissue, confirms the diagnosis and checks for liver damage.
Treatment
Losing weight is the first step in treating this disease. Losing weight can reduce fat in the liver, inflammation, and scarring. Regular exercise can also help reduce fat in the liver. The FDA has approved two medicines for the more serious form of the disease. Rezdiffra (resmetirom) was approved in March 2024 for adults with NASH and moderate to advanced liver scarring who do not have cirrhosis. Doctors use it along with diet and exercise. Wegovy (semaglutide) was approved in August 2025 for adults with MASH and moderate to advanced scarring. Rezdiffra can cause drug-induced liver toxicity and gallbladder problems. Your doctor may stop it if signs of worsening liver function develop. Do not stop any medicine unless your doctor tells you to. Wegovy is not for people with a personal or family history of medullary thyroid cancer, a cancer of the thyroid gland. Talk with your doctor before using vitamins or herbal products, because some can harm the liver. If NASH leads to cirrhosis, doctors treat its complications. If cirrhosis leads to liver failure, you may need a liver transplant.
When to see a doctor
Call 911 or go to the emergency room if you vomit blood, feel very confused, have chest pain or discomfort lasting two minutes or more, have trouble breathing, or faint. Talk to your doctor if you feel tired or have discomfort in the upper right side of your belly. The disease is more common in people who have obesity or type 2 diabetes. See a doctor right away if you notice jaundice, yellowing of the skin and eyes, because it can be a sign of liver damage.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can check your height and weight and order blood tests, including liver function tests.
Common questions
Can fatty liver disease go away?
It can get better with weight loss. Losing weight can reduce fat in the liver, inflammation, and scarring. Regular exercise can help you lose weight and reduce fat in the liver.
Is it caused by alcohol?
No. Heavy alcohol use causes a different disease called alcohol-associated liver disease. This disease happens in people who do not drink heavily.
What happens if it is not treated?
Some people develop NASH, the form with inflammation and liver damage. Over time it can lead to cirrhosis, which is severe scarring of the liver, or to liver cancer. If cirrhosis leads to liver failure, you may need a liver transplant.
Do I need medicine for it?
It depends. Weight loss and exercise come first. The FDA has approved two medicines for adults with NASH and moderate to advanced liver scarring: Rezdiffra (resmetirom) and Wegovy (semaglutide). Rezdiffra can harm the liver, and Wegovy is not for people with a family history of medullary thyroid cancer. Ask your doctor before taking supplements, since some can damage the liver.
How common is it?
MASLD is the most common long-term liver disease. About 6% of U.S. adults have MASH, the more serious form.
Sources
- MedlinePlus - Steatotic Liver Disease
- U.S. Food and Drug Administration - FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease
- U.S. Food and Drug Administration - FDA Approves Treatment for Serious Liver Disease Known as MASH
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
