Fatty Liver Symptoms: Top 8 Symptoms (w/ Online Quiz)

Updated in December 2023

The main symptoms of fatty liver are abdominal pain, bloating, excessive fatigue, loss of appetite, pale stools and yellow skin and eyes.

However, it is important to note that fatty liver may not cause any symptoms at all. Also, the signs or symptoms are not very specific, which is why a full work-up is needed to rule out other conditions in order to reach a fatty liver diagnosis. 

Fatty liver is generally not a serious condition, but when it is left untreated, it can lead to decreased liver function and cirrhosis, which may require a liver transplant if it reaches severe stages.

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Top symptoms

The classic symptoms of fatty liver are: 

  1. Loss of appetite
  2. Excessive fatigue
  3. Abdominal pain, particularly on the upper right side
  4. Constant headache
  5. Abdominal bloating 
  6. Itchy skin
  7. Yellow eyes and skin
  8. White stool 

In the initial phases of fatty liver, signs and symptoms may not be noticeable. However, as the illness progresses and liver function becomes compromised, the symptoms gradually start to emerge.

Fatty liver often does not cause any specific symptoms, and diagnosis is usually confirmed during routine assessments. In addition, fatty liver is not a serious condition, although if left untreated, it can lead to decreased liver functioning and cirrhosis.

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Online symptom checker

If you suspect you may have fatty liver, enter your symptoms below to assess your risk: 

  1. 1. Loss of appetite?
  2. 2. Pain in the upper right side of the belly?
  3. 3. Swollen belly?
  4. 4. Whitish stools?
  5. 5. Frequent tiredness?
  6. 6. Constant headache?
  7. 7. Nausea and vomiting?
  8. 8. Yellowish in the eyes and skin?

Fatty liver grades

Fatty liver can be classified into grades based on the amount of fat accumulated in this organ: 

  • Grade 1 fatty liver: Less than 33% of liver cells are affected
  • Grade 2 fatty liver: Between 33 to 66% of liver cells are affected
  • Grade 3 fatty liver: Over 66% of liver cells are affected 

The accumulation of fat in the liver is a silent process, meaning it may not cause any symptoms. Some patients may just notice some fatigue and a mild abdominal pain. Other symptoms, like yellow skin or eyes, are generally related to a higher grade of fatty liver. Liver inflammation and fibrosis can also occur as a result of fatty liver.  

Confirming a diagnosis

Diagnosis should be confirmed by a liver specialist, gastroenterologist or family doctor. This condition is usually noted through an ultrasound, however CT scans, MRIs or a biopsy can also reveal fat accumulation in the liver. 

Other tests, like liver enzyme tests (GGT, ALT or AST) and bilirubin tests can be useful to evaluate liver function. However, only a biopsy or imaging tests can show whether fibrosis or active inflammation are present. 

Possible causes 

It is not yet well known why fat starts to accumulate in the liver, even through this topic as been very studied. However, there are risk factors that promote fat accumulation and the progressive loss of liver function. 

Risk factors include:

  • Poor diet habits
  • Sedentary lifestyle
  • Frequent and excessive alcohol intake
  • History of high cholesterol 

Read about what else can cause liver pain and how it is treated. 

Treatment options

Fatty liver, particularly in its initial stages, can be treated with diet changes, regular physical activity, weight loss and management of chronic illnesses like diabetes, hypertention and high cholesterol. 

In addition, it is important to stop smoking and drinking, and to reduce overall intake of fatty foods and simple carbohydrates, like white bread, pizza, red meat, sausages, butter and frozen food. Your diet should be rich in whole grains, like whole wheat flour, whole rice and pasta, as well as fruit, vegetables, fish, lean meats, milk and dairy products. 

Check out our tips for a fatty liver diet, and be sure to check-out our sample meal plan to help get you on track.