VoltraFatty liver disease: what reverses it
Fatty liver disease, now called MASLD, is fat in the liver together with at least one cardiometabolic risk factor, in people who don't drink harmful amounts of alcohol [1]. It usually causes no symptoms [4]. The main treatment is weight loss: European guidelines advise losing at least 5% of your weight to reduce liver fat, 7–10% to improve inflammation and at least 10% to improve fibrosis [1].
What it is
MASLD stands for metabolic dysfunction-associated steatotic liver disease. It replaced the name non-alcoholic fatty liver disease (NAFLD) in 2023, after a consensus of 236 experts from 56 countries; the new definition needs at least 1 of 5 cardiometabolic risk factors [3]. Those include overweight (a BMI of 25 or more, or 23 or more in people of Asian ethnicity) and prediabetes [1].
It usually causes no symptoms [4], which is why many people find out from a scan or blood test done for something else. Saudi Arabia's health ministry lists fatty liver disease among the most common causes of cirrhosis, often in people with obesity or diabetes [5].
How common it is in the Gulf
| Where or who | Share with MASLD | Kind of figure |
|---|---|---|
| Middle East and North Africa, general population | 39.4% | Pooled studies [6] |
| Kuwait | 45.4% | Model estimate [6] |
| Saudi Arabia, 2017 → 2030 | 25.7% → 31.7% | Projection [7] |
| Saudi people with diabetes | 47.8–72.8% | 4 studies [8] |
Worldwide, the European guideline puts it at more than 30% of adults [1]. The Middle East figure pools studies, and it rose from 35.4% (2008–2016) to 46.2% (2017–2020) [6]; the country figures, with Kuwait the highest in the region, are model predictions [6]. The Saudi figures are projections from a model that assumed 30% of people aged 15 or over had it in 2015 [7].
How much weight to lose
| Goal | Weight to lose | At 90 kg (calculated) |
|---|---|---|
| To reduce liver fat | ≥5% | 4.5 kg |
| To improve inflammation | 7–10% | 6.3–9 kg |
| To improve fibrosis (scarring) | ≥10% | 9 kg |
European guideline recommendation [1].
The US guidance is similar: losing 3–5% of body weight improves liver fat, and more than 10% is generally needed to improve inflammation and fibrosis [2]. It is hard to reach: few people (10% or fewer) achieve effective weight loss in a year even with structured programmes, and fewer than half of those keep it off for 5 years [2]. Aim for a steady loss you can hold; our cutting guide covers the pace.
People with a normal weight get it too. For them the target is a 3–5% loss, and in a 12-month trial that much led to remission in half of the participants without obesity [1].
What to eat
- A Mediterranean-style diet. The European guideline recommends improving diet quality along those lines, limiting ultra-processed food rich in sugars and saturated fat, and avoiding sugar-sweetened drinks [1].
- Sugary drinks. In one study, 4 or more servings of soft drinks a week went with a 45% higher risk of developing MASLD [1]. The US guidance says too much fructose raises the risk regardless of calories [2].
- A calorie deficit if you're overweight, with limited carbohydrates and saturated fat and plenty of fibre and unsaturated fats [2].
- Fasting windows: there's very little evidence that time-restricted eating beats ordinary calorie restriction for liver fat [1]. See our intermittent fasting guide.
Exercise
The European guideline recommends activity to reduce liver fat, preferably more than 150 minutes a week of moderate or 75 minutes of vigorous exercise [1]. The US guidance says regular moderate exercise for 150 minutes a week, or adding more than 60 minutes a week, can prevent or improve the disease, with benefits independent of weight loss [2].
Coffee, supplements and herbs
Coffee: observational studies link 3 or more cups a day with less liver disease. The US guidance says it could be recommended if you have no reason to avoid it [2]; the European guideline says no firm conclusions can be drawn [1].
Supplements and herbs: the European guideline says "nutraceuticals cannot be recommended", because there is insufficient evidence that they work or are safe [1].
Should everyone be tested?
No. Both guidelines advise against screening the general population [1] [2]. If you have risk factors such as diabetes or obesity, ask your doctor what tests suit you.
In Voltra
Voltra can't diagnose or treat liver disease. It helps with what the guidelines lean on: a daily calorie target for steady weight loss, food logging, where the You tab's Eat section shows your sugar and saturated fat, and your steps and workouts.
Frequently asked
Can fatty liver be reversed?
Often, with weight loss. European guidelines say losing at least 5% of your weight reduces liver fat; in people without obesity, a 3–5% loss led to remission in half of those in one 12-month trial.
What is the best diet for fatty liver?
A Mediterranean-style diet, less ultra-processed food rich in sugars and saturated fat, no sugar-sweetened drinks, and a calorie deficit if you're overweight.
Does coffee help fatty liver?
Observational studies link 3 or more cups a day with less liver disease. US guidance says it could be recommended; European guidance says no firm conclusions can be drawn.
Do supplements or herbs treat fatty liver?
The European guideline says they can't be recommended: there isn't enough evidence that they work or are safe.
Sources
- EASL, EASD and EASO (2024). EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 81:492–542; co-published in Obesity Facts. Recommendations on screening, weight loss, diet, exercise, coffee and nutraceuticals.
- Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. (2023). AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77(5):1797–1835. Treatment section and Table 7.
- Rinella ME, Lazarus JV, Ratziu V, et al. (2023). A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 79(6):1542–1556. Abstract.
- دليل MSD الإرشادي، إصدار المستخدم (٢٠٢٥). داء الكبد الدهني (تَنَكُّس دُهنِي). In Arabic.
- وزارة الصحة، المملكة العربية السعودية (١٤٤٧ هـ). تليف الكبد. In Arabic.
- Younossi ZM, Golabi P, Paik J, et al. (2024). Prevalence of metabolic dysfunction-associated steatotic liver disease in the Middle East and North Africa. Liver Int 44(4):1061–1070. Abstract. Country figures are model predictions.
- Alswat K, Aljumah AA, Sanai FM, et al. (2018). Nonalcoholic fatty liver disease burden – Saudi Arabia and United Arab Emirates, 2017–2030. Saudi J Gastroenterol 24(4):211–219. A modelling study.
- Albeshry AM, Alasmari MA, Alshahrani JA, et al. (2023). Prevalence of non-alcoholic fatty liver disease among diabetic mellitus patients in Saudi Arabia: systematic review and meta-analysis. Cureus 15(12):e51092. Four studies, with large differences between them.
Sources checked on 30 September 2026.
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