Symptoms & Causes

Non-Alcoholic Fatty Liver Disease (NAFLD)

What is Non-Alcoholic Fatty Liver Disease (NAFLD)?

What is Non-Alcoholic Fatty Liver Disease (NAFLD)?

Non-alcoholic fatty liver disease (NAFLD) happens when fat builds up in the liver of individuals who don’t drink much alcohol.

A person with non-alcoholic fatty liver disease has fat deposits inside the liver, which can cause inflammation, such as non-alcoholic steatohepatitis (NASH). If not treated, NAFLD can progress to liver cirrhosis, leading to a liver transplant if the damage is too severe.

According to the American Liver Foundation, about 100 million individuals in the United States are diagnosed with non-alcoholic fatty liver disease.

Types of NAFLD


There are two types of non-alcoholic fatty liver disease: simple fatty liver and non-alcoholic steatohepatitis (NASH).

  • Non-alcoholic fatty liver develops when fat deposits accumulate in the liver, but there is little or no inflammation or liver cell damage. Simple fatty liver is less likely to cause liver damage or complications.
  • Non-alcoholic steatohepatitis (NASH) is a type of NAFLD in which excess fat buildup in the liver results in inflammation. NASH is a more aggressive form of fatty liver disease that may cause fibrosis of the liver and other serious conditions if left untreated.

Stages of NAFLD


Fatty liver is a dynamic disease and may get better or worse over time.

  • Simple fatty liver (steatosis) – Excess fat builds up in the liver. Simple fatty liver may not progress into more severe stages.
  • Steatohepatitis – This stage is often referred to as NASH. An excess amount of fat in the liver is accompanied by inflammation.
  • Fibrosis – A persistent and untreated inflammation in the liver that might progress to scarring by this stage, yet the liver can still function normally.
  • Cirrhosis – Scarring is more severe and widespread and can impair liver function. A liver transplant may be necessary if liver failure and/or liver cancer are present.

Signs & Symptoms of NAFLD


NAFLD is often silent and provides few signs or symptoms in the early stages. When patients with NAFLD have symptoms, right-sided abdominal pain and fatigue are the most common ones observed.

If NAFLD progresses to cirrhosis, the following symptoms may occur:

  • Nausea
  • Abdominal pain
  • Confusion
  • Fluid buildup in the abdomen
  • Easy bruising or bleeding
  • Weight loss
  • Weakness or fatigue
  • Loss of appetite
  • Pale stools
  • Swelling in the legs
  • Weblike blood vessels under the skin
  • Breast enlargement in men
  • Itchy skin
  • Jaundice
  • Dark-colored urine

The medical specialists at NewYork-Presbyterian offer the latest therapies and comprehensive care for individuals living with NAFLD.

Children and teenagers can also develop NAFLD, with boys being more susceptible than girls. The following conditions increase the chances of children developing NAFLD:

  • Obesity
  • Prediabetes and type 2 diabetes
  • High cholesterol and triglycerides
  • Insulin resistance
  • Rapid weight loss

Our NewYork-Presbyterian Morgan Stanley Children’s Hospital is available to provide care from expert pediatricians just for children and adolescents with fatty liver disease—the only one of its kind in the tri-state area.

What Causes NAFLD?


With fatty liver disease, excess fat accumulates in liver cells, contributing to severe liver impairment if left untreated. Many factors contribute to NAFLD, but the specific cause is not known. Conditions that are commonly associated with NAFLD include insulin resistance or diabetes, obesity, certain genetic conditions, high cholesterol circulating in the blood.

Risk Factors

Risk Factors

There are many risk factors for fatty liver disease. Since most people with NAFLD aren’t even aware that they are affected, it is a good idea to use this list as a way to gauge whether you may be at risk for developing this condition. But remember that having risk factors does not mean you’ll undoubtedly develop NAFLD in the future.

It’s a good idea to be aware of these symptoms and discuss prevention strategies with your healthcare provider:

  • Having a weight in the overweight or obese range
  • Insulin resistance
  • Having type 2 diabetes
  • High cholesterol
  • High triglycerides
  • Metabolic syndrome

Other risk factors for NAFLD include:

  • A family history of liver disease
  • Polycystic ovary syndrome (PCOS)
  • Rapid weight loss
  • Obstructive sleep apnea
  • Exposure to certain toxins



Some individuals with NAFLD develop non-alcoholic steatohepatitis (NASH), a more aggressive form of fatty liver disease characterized by liver inflammation that can progress to advanced liver tissue scarring called cirrhosis and liver failure.

Complications of cirrhosis can include:

  • High blood pressure.
  • Swelling in the legs and abdomen.
  • Enlargement of the spleen.
  • The body will not effectively fight off infections.
  • The body will have a more challenging time processing nutrients absorbed from the small intestine.
  • The body will develop jaundice due to the liver’s impaired ability to detox.
  • Increased risk of liver cancer for people with pre-existing cirrhosis.



Preventing fatty liver disease is possible by following follow a healthy lifestyle that includes:

  • Limiting or avoiding alcohol
  • Maintaining a healthy weight
  • Getting at least 30 minutes of exercise most days of the week
  • Eating a nutrient-dense, healthy diet that’s low in saturated fat, trans fat, and added sugars
  • Managing blood sugar, triglyceride levels, and cholesterol levels
  • Managing diabetes
Get Care

Trust New York-Presbyterian for Non-Alcoholic Fatty Liver Disease (NAFLD) Care

Nonalcoholic fatty liver disease is a silent killer. Most people with this condition usually experience significant symptoms starting in the more advanced stages of the disease. That’s why seeking treatment for NAFLD is important. You can begin by scheduling an appointment with our expert care team.

At NewYork-Presbyterian, you’ll have access to our expert care team, which includes hepatologists (liver specialists). Call to schedule an appointment today.