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What Is Fatty Liver Disease, and Why Think About It Before Dry July?

Fatty liver disease is a build-up of excess fat in the liver that affects around one in three Australian adults, and it usually causes no symptoms at all. It is now medically known as MASLD, and for many people it can be improved, and sometimes reversed, through changes to diet, alcohol intake, physical activity and metabolic health. Because blood tests do not always show the full picture, further assessment may be helpful when risk factors are present.

  • Fatty liver means fat makes up more than 5% of the liver’s weight.
  • It is often silent, so most people do not know they have it.
  • The main drivers are excess body weight, diet and alcohol.
  • Losing 7 to 10% of body weight can meaningfully improve it.
  • A blood test and a GP visit are the usual first steps.

What “fatty liver” actually means

Fatty liver disease describes a liver that is storing more fat than it should. You have fatty liver when fat makes up more than 5% of the total weight of the liver. A small amount of fat in the liver is normal; the concern begins when that fat accumulates and, over time, may lead to inflammation and scarring in some people.

It is common. Healthdirect notes that about one in three Australian adults has fatty liver disease. That figure is one reason the condition is now discussed so widely, and why an awareness month such as Dry July is a useful prompt to pause and consider your own liver health.

Why the name changed to MASLD

You may have seen this condition called “non-alcoholic fatty liver disease”, or NAFLD. In 2023, a global consensus of liver specialist societies updated the terminology. NAFLD became MASLD (metabolic dysfunction-associated steatotic liver disease), and the more advanced inflamed form, previously NASH, became MASH.

The change was not just cosmetic. The newer name reflects the underlying driver more honestly. MASLD describes fat in the liver together with at least one cardiometabolic risk factor, such as raised blood pressure, raised blood sugar or type 2 diabetes, raised triglycerides, or excess weight around the middle. In plain terms, fatty liver is closely tied to the same factors that affect heart and metabolic health. Throughout this article we use the familiar phrase “fatty liver” alongside the current term, MASLD.

The condition is usually silent

One of the most important things to understand about fatty liver is how quietly it can develop. Fatty liver disease usually does not cause symptoms. Many people feel completely well and only discover it incidentally, for example when a routine blood test shows slightly raised liver readings, or when a scan done for another reason picks up fat in the liver.

Because it is often silent, fatty liver is easy to overlook. That is precisely why general awareness matters: understanding your own risk factors, rather than waiting for symptoms, is the more useful approach. Blood tests are common and useful, but liver readings can sometimes stay within the normal range even when more advanced disease is present. They also do not measure how much fat has built up or reliably show how much scarring has developed.

If you notice ongoing tiredness or discomfort under the right ribs, these symptoms are not specific to fatty liver and should be discussed with your GP rather than self-diagnosed.

Where Dry July fits in

Dry Julyis an Australian not-for-profit campaign that invites people to go alcohol-free for the month of July to raise funds for cancer support services. It is a fundraising and awareness initiative, and a natural moment for many Australians to reflect on how much they drink.

Alcohol is one contributor to liver fat, although it is not the only one. Excess alcohol can drive fat accumulation in the liver, and reducing intake is one part of supporting liver health. For people whose liver fat is driven by both metabolic factors and higher alcohol intake, liver specialists now recognise a distinct category called MetALD, a reminder that diet and alcohol often act together.

To put intake in context, the national guidance from the NHMRC, is that healthy adults should drink no more than 10 standard drinks a week and no more than 4 on any one day, with one standard drink containing 10 grams of pure alcohol. A month off alcohol will not, on its own, undo fatty liver, but using Dry July as a prompt to review your usual drinking is a sensible starting point.

Winter eating and the metabolic picture

The cooler months tend to bring richer, more energy-dense meals and less physical activity. Over a season, that shift can quietly add to the cardiometabolic load that underlies fatty liver. Because MASLD is so closely linked to weight, blood sugar and blood fats, the winter period is worth approaching with a little more attention rather than guilt.

This is not about a restrictive crash diet. The evidence points towards a sustainable dietary pattern. A review in the International Journal of Molecular Sciences, 2021 found that the Mediterranean diet is recommended as the diet of choice for fatty liver. This means an eating pattern rich in vegetables, legumes, wholegrains, olive oil and fish, and lighter on ultra-processed foods, refined sugars and alcohol. Warm, hearty meals built around those ingredients can still suit the season comfortably.

Can fatty liver be improved or reversed?

For many people, yes. Making changes to your lifestyle can improve fatty liver and even reverse it. The liver has a notable capacity to recover when the factors driving fat accumulation are addressed.

The evidence is encouraging on what degree of change makes a difference. A systematic review and meta-analysis in PLoS One reported that a 7 to 10% reduction in body weight improves steatosis, inflammation and fibrosis in fatty liver. For someone weighing 90 kilograms, that is roughly 6 to 9 kilograms, achieved gradually. Individual results vary, and any weight-loss plan is most safely guided by a health professional. The broad message is hopeful because meaningful, achievable change can shift the picture.

Practical, evidence-aligned steps that many people find manageable include:

  • Building meals around the Mediterranean pattern described above.
  • Reviewing alcohol intake against the national guidelines.
  • Adding regular physical activity to your weekly routine.
  • Managing related conditions such as blood pressure, cholesterol and blood sugar with your GP.

A non-invasive way to check liver fat and stiffness

Many people want a clearer picture of their liver health before any symptoms appear. Blood tests are a common first step, but they do not measure liver fat, and they may not reliably show how much scarring has developed. This means a person can sometimes need more information than blood results alone can provide.

Beyond blood tests and standard imaging, a non-invasive scan called liver elastography is now one of the tools available. It uses ultrasound to measure liver stiffness, a marker of possible scarring, and can also estimate the amount of fat in the liver, all without a needle, an injection or radiation. The scan takes only a few minutes, and the readings are interpreted by a specialist alongside your history and blood tests rather than standing alone as a diagnosis.

At The Centre for Gastrointestinal Health, liver elastography is available as part of liver care. The results are interpreted alongside your history, blood tests and risk factors, rather than used as a diagnosis on their own. It is not necessary for everyone, and whether it is appropriate for you is a clinical decision best made with your GP or specialist. You can read more on our Liver Elastography page.

When to seek assessment

Because fatty liver is usually silent, the most reliable path is not to wait for symptoms but to discuss your risk factors with your GP, who can arrange a simple liver function blood test if appropriate. If results or risk factors suggest a closer look is warranted, your GP may refer you to a gastroenterologist or hepatologist for assessment.

At The Centre for Gastrointestinal Health, our team provides assessment and ongoing care for a range of liver conditions, including fatty liver disease. You can read more about how we approach this on our Liver Disease Management page, and our Accredited Practising Dietitians offer tailored dietary support through our Nutrition and Dietetic Services. If you would like to arrange care with a referral from your GP, you are welcome to contact he Centre.

This article is general information only and is not a substitute for personalised medical advice. It does not take your individual circumstances into account. Please speak with your GP or a qualified specialist about your own health, including before making changes to your diet or alcohol intake.

Sources and Further Reading

 

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