Woes of a fatty liver

You feel healthy and you may have normal body weight. However, that does not guarantee that you are free from fatty liver, a condition where excess fats accumulate in liver cells.

The condition is harmless at the beginning, but will gradually lead to scarring or severe diseases, including liver cancer, causing the liver function to deteriorate.

Malaysian Liver Foundation president Tan Sri Dr Mohd Ismail Merican says fatty liver is fast becoming a major problem globally.

"Although we have yet to initiate our own study on a regional scale, there are estimates from other published studies which say at least two thirds of Malaysians have fatty liver," he says.

Fatty liver is a regular feature of alcoholic liver disease, he says, but people who are obese or have normal weight are prone to get the condition too. In this case, it is called Non-Alcoholic Fatty Liver Disease (NAFLD).

"Based on the National Health and Morbidity Survey 2011, 44.5 per cent of Malaysians are either overweight or obese. A study shows that 94 per cent of people with Body Mass Index (BMI) of more than 30 (obese) and 67 per cent of those with BMI between 25 and 30 (overweight) have fatty liver. About 25 per cent of people with normal weight also have the same condition, no thanks to consuming too much food with saturated fat," he says, adding that about 40 to 70 per cent of diabetics may have fatty liver.


Dr Mohd Ismail explains that fatty liver will become a real problem when it reaches the Non-Alcoholic Steatohepatitis (Nash) stage.

"Nash is when the inflammation of the liver occurs and this will lead to scarring (fibrosis). The most severe condition is when it reaches the irreversible or end stage - when it becomes cirrhosis or liver cancer," he says, adding that people with fatty liver as well as other liver diseases such as hepatitis and liver cancer, do not know that they have the conditions because there are no significant signs or symptoms at the early stage.

"Usually the symptoms are as common as a tired feeling. The condition can only be detected through check-ups. This is why 80 per cent of patients come to see the doctor only when they have already reached the irreversible stage," he says.


More than 500 vital functions have been identified with the liver but mainly, it regulates chemical levels in the blood and excretes bile that helps to carry away waste and breaks down fats in the small intestine during digestion.

"With its multiple functions, the liver is like a 'workhorse' in our body. That's why it's important for us to take care of our liver simply by practising a healthy lifestyle," says Dr Mohd Ismail.

Fatty liver, he says, is a reversible condition and can be prevented by changing one's diet and exercising regularly.

"Try to maintain a healthy weight and most importantly, reduce the intake of fat, sugar and salt. Avoid fast food and eat more vegetables and fruit," he advises. "Avoid a sedentary lifestyle and exercise regularly."

He also recommends health check-ups, particularly for those with a family history of liver diseases.