Fatty liver disease is one of the most common liver conditions in the UK. Around 1 in 5 people are thought to have the early stages of it. Most of them do not know.
That is because fatty liver symptoms are quiet. They are easy to brush off as a busy week, a poor night’s sleep, or just getting older. Many people only find out when a blood test or scan for something else picks it up by chance.
This guide explains the signs most people miss, why they are so easy to overlook, and when it is worth speaking to your GP.
What is Fatty Liver Disease?
Your liver is meant to hold a small amount of fat. Fatty liver disease is when too much fat builds up inside it.
Doctors now call the most common type MASLD, which stands for metabolic dysfunction-associated steatotic liver disease. You might still see the older name, NAFLD. Our simple guide to MASLD and NAFLD explains what the two names mean and why they changed.
The condition is closely linked to carrying extra weight, type 2 diabetes, high blood pressure and high cholesterol. Over many years, extra fat can cause swelling in the liver, and then scarring. Scarring is much harder to undo, which is why spotting it early matters.
Why fatty liver symptoms are so easy to miss
Your liver is very good at coping. It can keep working well even when it is under a lot of strain, so it rarely sends out loud warning signals in the early stages.
When fatty liver symptoms do appear, they tend to be:
- Mild. Nothing bad enough to make you stop what you are doing.
- Vague. They could be caused by lots of everyday things.
- Slow. They creep in over months or years, so you get used to them.
Put those three things together, and it is easy to see why the liver is often the last thing anyone thinks about.
The signs most people miss
| Sign | What it can feel like | Why people miss it |
| Tiredness | Feeling worn out, even after a full night’s sleep | Blamed on work, stress or a busy family life |
| Ache under the right ribs | A dull ache, heaviness or feeling of fullness on the upper right side of your tummy | Mistaken for indigestion, wind or a pulled muscle |
| Feeling generally unwell | Feeling run down or “not quite right” without a clear reason | Put down to a cold coming on or being a bit low |
| Brain fog | Finding it harder to focus or remember things | Blamed on poor sleep, age or screen time |
| Weight gain around the middle | Your waistline growing, even if your weight looks normal elsewhere | Seen as a looks issue rather than a health one |
| Dark, velvety skin patches | Darker skin on the neck, armpits or groin | Thought to be dirt, a rash or nothing at all |
| An odd blood test result | Your GP mentions raised liver levels after a routine check | Not followed up because you feel fine |
A quick note on the skin patches. They are not caused by the liver itself. They are often a sign that the body is struggling to use insulin properly, which is one of the biggest risk factors for fatty liver disease.
Who is more likely to have fatty liver disease?
Fatty liver symptoms are worth taking more seriously if you also have one or more of these:
- Type 2 diabetes or prediabetes
- High blood pressure
- High cholesterol
- Extra weight, especially around your waist
- A family history of diabetes or liver problems
Type 2 diabetes is one of the strongest links of all. If you would like to understand why the two conditions so often appear together, read our article on fatty liver disease and type 2 diabetes.
It is also worth knowing that you do not have to be overweight to have fatty liver disease. People who are a healthy weight can still have it, especially if they carry fat around their middle.
Later signs you should never ignore
If fatty liver disease is left to get worse, it can lead to serious scarring, known as cirrhosis. At this stage, the signs are much harder to miss. Speak to your GP straight away if you notice:
- Yellowing of the skin or the whites of your eyes
- Itchy skin that will not go away
- Swelling in your legs, ankles, feet or tummy
- Very dark pee or pale poo
- Bruising more easily than usual
The NHS page on the symptoms and stages of fatty liver disease explains how the condition can move from one stage to the next.
How Fatty Liver Disease is checked
There is no single test that tells you everything, so doctors usually build up a picture using a few different checks:
- Blood tests to look at liver levels. These help, but results can look normal even when there is fat in the liver.
- An ultrasound scan, which is painless and can show fat in the liver.
- A FibroScan, a special scan that measures how stiff the liver is. This helps show whether any scarring has started.
If you have any of the signs above and one of the risk factors, ask your GP about your liver directly. You do not have to wait for them to bring it up.
The good news
In its early stages, fatty liver disease can often be improved. The things that help most are simple, even if they take time:
- Losing a small amount of weight, if you carry extra
- Cutting back on sugary drinks and heavily processed food
- Moving more across the week
- Keeping alcohol low, or stopping
- Keeping blood pressure, cholesterol and blood sugar under control
To see what the latest research says about recovery, read our guide: can fatty liver disease be reversed?
There is still no medicine licensed in the UK made just for fatty liver disease. That is why clinical research is so important. At 4MCS, we run studies testing possible new treatments, approved by the MHRA and carried out to strict safety standards. Participants have regular health checks and liver tests, and support from our research team throughout. You can find out more about our fatty liver clinical trial, including who can take part.
Find a fatty liver trial near you
We run fatty liver disease studies from two clinics, and both are looking for participants now.
- London: our Ilford clinic in East London has been running studies since 2019. It is a short walk from Ilford railway station and served by several bus routes.
- Manchester: our Swinton clinic in Greater Manchester is based in M60 Office Park, with free parking on site and about ten minutes from Swinton train station.
To see every study we are recruiting for, visit our current clinical trials page.
Most fatty liver studies ask that you are 18 or over, have a diagnosis of fatty liver disease, and have at least one linked condition such as type 2 diabetes, high blood pressure or extra weight. A research nurse will talk everything through with you first, and you can stop taking part at any time. Travel expenses are covered.
Call us free on 03300 575 838, email info@4mcs.co.uk, or register your interest online.
FAQ:
Can fatty liver go away?
Yes, fatty liver can often be reversed in its early stages, especially by losing extra weight, eating a healthier diet, being more active and cutting down on alcohol.
What is the no. 1 food that causes fatty liver?
Foods and drinks high in added sugar, especially sugary fizzy drinks, are often seen as the biggest cause, because the liver turns extra sugar into fat.
What drink reverses fatty liver?
No single drink can reverse fatty liver, but swapping sugary drinks and alcohol for water, and drinking plain coffee without added sugar, may help protect the liver as part of a healthier lifestyle.
What are 5 signs of a fatty liver?
Fatty liver often has no signs at first, but five possible signs are feeling very tired, an ache or discomfort in the upper right side of your tummy, losing weight without trying, feeling weak, and, in later stages, yellowing of the skin or the whites of the eyes.
This article is for general information only and is not medical advice. If you are worried about your health, please speak to your GP or another healthcare professional.
