Nonalcoholic Steatohepatitis (NASH)
Treatment Overview
There is no proven effective treatment for nonalcoholic steatohepatitis (NASH). But making lifestyle changes that decrease your risk of liver damage may help to stop the progression of the disease.
In general, treatment is aimed at managing conditions that contribute to NASH or make it worse. These include obesity, high cholesterol, and diabetes. If you have NASH, you should also minimize your alcohol use and stop taking any medicines that may be harmful to your liver.
Controlling your weight and cholesterol
Losing weight and lowering your cholesterol can help stop or limit the damage done to your liver. The most effective way to do this is to modify your diet and get regular exercise.
Experts recommend that you gradually lose 10% of your total body weight, at a rate of no more than 1 to 2 pounds per week.3 Losing just 10% of your weight can help your body use insulin more effectively. This would mean, for example, losing 20 lb (9.1 kg) if you weigh 200 lb (90.7 kg). This can decrease the amount of fat that builds up in your liver and limit the damage it does to the cells of your liver.
But it is very important that you lose weight gradually, not rapidly. Rapid weight loss can cause greater harm to your liver by increasing inflammation and scar tissue. You should lose 1 to 2 pounds per week until you have met your goal of 10% of your total body weight.
Avoid crash or fad diets. Weight-loss drugs have not been proven effective for the treatment of NASH, and surgeries such as intestinal bypass can make NASH worse.
Weight loss is best achieved through modifying your diet and getting more exercise. For more information on obesity and how you can safely and effectively lose weight, see the topics Obesity and Healthy Weight.
Lowering your cholesterol can also help your liver. Although there is no evidence that cholesterol-lowering drugs can help stop damage to your liver from NASH, following a heart-healthy diet and lowering your cholesterol as part of a weight-loss plan may help. For more information on high cholesterol and how you can reduce it, see the topic High Cholesterol.
One safe and effective way of controlling your cholesterol without taking medicine is by following a program called Therapeutic Lifestyle Changes. This program involves losing excess weight, increasing your activity, and eating meals that are low in saturated fat. Done together, these changes may help you lower your cholesterol by 10% to 20%.
Controlling diabetes
Diabetes is common in people who have NASH—up to 75% of people with NASH have diabetes. Resistance to insulin contributes to the development of NASH. If you have diabetes, keep your blood sugar in a safe range to help prevent fat buildup in and damage to your liver.
For more information on controlling diabetes, see the topic Type 2 Diabetes: Living With the Disease.
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| Author: | Monica Rhodes | Last Updated: July 18, 2007 |
| Medical Review: | Kathleen Romito, MD - Family Medicine W. Thomas London, MD - Hepatology | |
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