Don’t just look at oil for fatty liver disease! Doctor: Liver fibrosis is the key

Liu Boren, director of the Cobot Clinic, said that weight loss, regular exercise and improved diet are important basic treatments for fatty liver. Blood sugar, blood pressure and blood lipids must also be controlled simultaneously; the picture is a situational photo.

When people find fatty liver during health check-ups, the first thing they think about is whether they eat too much fat? Liu Boren, president of Cobot Clinic, pointed out that when looking at fatty liver, one should not just look at whether there is fat in the liver, but more importantly, whether there is liver fibrosis. If you are overweight or obese, you should lose at least 5% of your weight, exercise regularly, improve your diet, and control your blood sugar, blood pressure, and blood lipids at the same time, so that you can proactively deal with it before your liver hardens.

Liu Boren posted on Facebook "Liu Boren Nutritional Functional Medicine Expert" to share that the current medical community's view of fatty liver is no longer limited to "whether there is oil in the liver." The more commonly used name in medicine is MASLD, which stands for "metabolic dysfunction-associated fatty liver disease." It often occurs together with metabolic problems such as obesity, excessive waist circumference, diabetes, high blood pressure, and high triglycerides. What really determines the long-term prognosis is not the fat itself, but whether the liver has begun to undergo fibrosis.

Fatty liver is most afraid of liver hardening

Liu Boren explained that the new MASLD clinical guidelines in 2026 once again emphasize that progressive liver fibrosis is one of the most important prognostic factors for future cirrhosis, liver cancer, and liver-related death. In other words, fat accumulates in the liver. Once it is accompanied by inflammation and metabolic abnormalities for a long time, the liver may slowly form fibrous tissue.

He went on to say that just like a originally soft sponge gradually hardens, you may not feel it at all at first, and your liver function GOT and GPT may even show no obvious abnormalities. However, when it further develops into severe fibrosis and cirrhosis, the treatment will be completely different.

Liu Boren reminded that MASLD does not only occur in obese people. Some people have a normal weight, but if they have a lot of visceral fat and have abnormal blood sugar or triglycerides, they may also develop fatty liver. Therefore, in addition to weight, you should also pay attention to waist circumference, blood sugar, blood pressure, blood lipids and overall metabolic status.

Liu Boren said that the basic treatment for fatty liver is still based on lifestyle adjustment. If you are overweight or obese and lose at least about 5% of your body weight, you usually have a chance to improve liver fat. At the same time, you should exercise regularly, reduce sedentary time, and do at least about 150 minutes of moderate-intensity aerobic exercise per week.

Liu Boren suggested that the diet should reduce refined sugar, sugary drinks, excessive refined starches, and processed foods, while increasing vegetables, high-quality protein, whole grains, and better sources of fat. If you have diabetes, high blood pressure or hyperlipidemia at the same time, it is best to control them together.