How can we treat non-alcoholic fatty liver disease?

• Intensive lifestyle intervention with ≥7% weight loss diminishes liver inflammation; ≥10% weight loss can decrease liver fibrosis. Motivational interviewing to engage patient to create their preferred plan, cognitive behavioral therapy, weight loss, diet, and exercise provide the most enduring benefit. For more on motivational interviewing for NAFLD, please see our video and pocket guide for providers.
• Bariatric surgery for patients who meet criteria (e.g., 40 kg/m2 or >35 with comorbidity [e.g., diabetes, HTN]).
• Weight loss pharmacotherapy can help patients with NAFLD achieve weight loss.
• Future NAFLD therapies are promising but not yet FDA approved.

References

The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease
Practice Guidance from the American Association for the Study of Liver Diseases; Hepatology, 2018

VA NAFLD Treatment Considerations. Internal document.