By Peter G. Traber, M.D. on February 3, 2016
Are you one of the nearly 40% of Americans classified as obese or are you overweight and inexorably headed towards obesity? Has your physician ever suggested you lose weight or have you made a New Year’s resolution to go on a diet? Do you need any more motivation to lose weight? If you do, here’s one: losing weight can reverse fatty liver disease and keep your liver healthy. And the good news is you don’t have to lose all that much weight to see a major improvement.
In fatty liver disease – also known as non-alcoholic steatohepatitis, or NASH – fat globules accumulate in liver cells, leading to the death of some of those cells and the development of an inflammatory reaction. With years of chronic inflammation, scar tissue begins to form in the liver via a process called fibrosis. When the scar tissue becomes severe, a condition called cirrhosis, the liver architecture becomes distorted and the blood flow to the liver is altered, resulting in life-threatening complications and liver failure.
The prevalence of NASH has reached epidemic proportions with as many as 25 million U.S. adults having the disease, as reported in a recent Newsweek article entitled “NASH is the 21st century’s looming public health threat.” I was interviewed for this article, and Galectin Therapeutics and our NASH therapeutic GR-MD-02 have a prominent place in the discussion. The article accurately reflects the critical aspects of this disease. Specifically, in its early stages with mild fibrosis, the disease can be improved with lifestyle changes including weight loss. However, when fibrosis is advanced, and particularly when cirrhosis is present, weight loss has much less effect and the only resort may be a liver transplant. This is why our drug treatment is focused on patients with advanced fibrosis and cirrhosis.
Now let’s get back to the good news. If you have early stage NASH – meaning you have inflammation with early stages of fibrosis – weight loss will significantly improve the health of your liver. In a recent clinical study, all patients who lost at least 10% of their body weight had reductions in their fatty liver disease on liver biopsy, with 90% having complete resolution of NASH. Additionally, patients who lost less weight, including as little as 3% of their body weight, also had significant improvements. In all patients who lost weight, every aspect of NASH was improved including fat in liver cells, liver cell death, and inflammation. It is important to note 61% of the patients in this study had no fibrosis, and it was mild in those that had fibrosis.
As described in the Newsweek article, I can personally affirm that weight loss can improve one’s liver. An ankle injury I suffered during a college football practice resulted in multiple surgeries and forced me to stop exercising, and I gained a significant amount of weight – in the neighborhood of 50 pounds. This resulted in high blood sugar and elevated liver enzymes, indicating potential damage to my liver due to fatty liver disease. My physician prescribed anti-diabetic medication, but I decided it was best to focus exclusively on losing weight. I was successful in losing approximately 10% of my body weight, and I’m continuing to lose.
While I am not yet at my ideal body weight, the improvements are dramatic. My blood glucose is now normal and stays normal throughout the day (and I’m not taking diabetes medication), and my liver enzymes have decreased and are now within the normal range. Also, I feel much better and my clothes fit! The important point is that you do not need to get all the way to your ideal weight to see dramatic improvements in liver health and other important health benefits. This is not an all-or-nothing proposition, and every little bit helps.
If you are one of those people carrying around extra weight, get started losing weight now. It doesn’t take much weight loss to improve your liver health. There are many approaches to losing weight, which you should discuss with your healthcare provider. And don’t forget to combine your weight loss program with exercise, which has also been shown to improve liver health. I will return to a number of the important issues raised in the Newsweek article in future Perspectives. In the meantime, I’ll see you at the salad bar.
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Footnotes:
- Defined as a BMI over 30; BMI = weight (in pounds) x 703 ÷ height (in inches) ÷ height (in inches)
- Available online as of January 30, 2015 and in the print edition dated February 12, 2016
