What Is Non-Alcoholic Fatty Liver Disease?

Nonalcoholic fatty liver disease (NAFLD) is a silent condition that can affect anyone, regardless of age or lifestyle. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 24% of American adults have NAFLD. The condition frequently goes unnoticed until a person’s blood work reveals elevated liver enzymes or more severe complications arise, such as scarring or inflammation of the liver.,

Recognizing the subtle signs that indicate you might have NAFLD is essential, as early detection can significantly impact treatment and management. 

What is NAFLD, and how is NAFLD diagnosed? Read on to learn five sneaky signs that suggest you might have NAFLD, plus practical tips for reducing your risk. 

What Is NAFLD?

Fatty liver disease is often associated with heavy drinking or alcoholism. However, alcohol isn’t the only cause of liver disease. When too much fat builds up in the liver, it can cause inflammation and potential liver damage. Over time, this can lead to another type of liver disease called NAFLD .  While the cause isn’t 100% clear, it is often linked to overweight, obesity, type 2 diabetes, metabolic syndrome, high cholesterol and high triglycerides.

“The main cause of NAFLD is an imbalance between the amount of fat the liver produces or absorbs and its ability to break it down or export it,” explains Trista Best, M.P.H., RD, a registered dietitian with Balance One Supplements. “When the liver is exposed to excess fatty acids—often due to a high-calorie diet rich in sugars and unhealthy fats—it stores these fats, leading to fat accumulation within liver cells. Over time, this can lead to liver inflammation, scarring, and even more severe liver damage.”

NAFLD is often diagnosed through medical history, blood tests, physical exams and imaging tests, like ultrasound or MRI. These methods can help reveal fatty deposits in the liver and rule out other causes of liver damage.

5 Sneaky Signs You Might Have NAFLD

1. You Might Feel Excessively Tired

“Feeling unusually tired or sluggish is common with NAFLD,” says Best. “This happens because the liver is not functioning optimally, affecting your overall energy levels.” When the liver is overwhelmed with excess fat, it struggles to perform its vital functions, which can result in exhaustion.

2. You May Experience Pain or Discomfort In Your Upper Right Abdomen

Pain or discomfort in the upper right side of your abdomen could signal NAFLD. This is where the liver is located, and if it becomes inflamed or swollen due to fat build up, you might feel a dull, aching sensation.

3. You Might Experience Unintentional Gain Weight

Weight gain can be a contributor to NAFLD, especially if you have  metabolic syndrome. That’s because insulin resistance may increase fat storage in the liver, injuring its cells and their ability to function properly. “Some people with NAFLD might notice weight gain, especially around the abdomen, even without significant changes in diet or exercise,” says Best.

4. Your Pee May Be Dark

Dark-colored urine could indicate advanced NAFLD. This occurs when the liver cannot filter waste products effectively, increasing a yellow pigment called bilirubin. This compound is formed from the breakdown of red blood cells, processed by the liver, and excreted in bile—which darkens urine.

5. Your Skin or Eyes May Have a Yellow Tinge

When the liver is unable to process bilirubin, it can also lead to jaundice. “Although less common in NAFLD early stages, jaundice can occur if liver damage progresses, leading to a yellowish tint in the skin or eyes,” explains Best. 

Best Ways to Reduce Your Risk

These healthy lifestyle habits can lower your NAFLD risk and support liver health.

Maintain a Healthy Weight 

Research suggests that losing 7 to 10% of your body weight can reduce liver fat and fibrosis, a type of scarring that damages the liver. Aim for a balanced diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats while limiting added sugars, refined carbohydrates and saturated fats.

Limit Alcohol Intake 

While NAFLD isn’t caused by alcohol, excessive drinking can worsen liver damage. That’s why keeping your alcohol consumption in check can help protect your liver from additional stress and prevent further complications. For most healthy people, that translates to a maximum of one drink a day for women and two for men. However, many health authorities recommend limiting or even abstaining from alcohol if you have NAFLD.

Exercise Regularly 

Physical activity helps lower liver fat, improves insulin sensitivity, and supports weight management. Per the Physical Guidelines for Americans, aim for at least 150 minutes of moderate-intensity exercise each week (or 75 minutes if you exercise vigorously).

Manage Blood Sugar 

Maintaining stable blood sugar may help prevent liver damage and boost metabolic health. Conversely, having diabetes can increase your liver disease risk. That’s why controlling your blood sugar levels through a healthy diet, regular exercise and appropriate medication is crucial for reducing your NAFLD risk. 

The Bottom Line

Nonalcoholic fatty liver disease is a common but often overlooked condition affecting 1 in 4 Americans. It results from fat buildup in the liver, which can lead to inflammation, scarring, and cirrhosis if left untreated. Recognizing early warning signs such as excessive fatigue, upper abdominal pain, weight gain, dark urine, and jaundice is crucial for managing the condition. To reduce your NAFLD risk, focus on maintaining a healthy weight through a balanced diet and regular exercise, limit alcohol consumption, and keep blood sugar levels in check.