Even Skinny People Can Have a Fatty Liver

Having a fatty liver is associated with a marked increase in heart attacks and liver damage, even in people who are not overweight (Clin Gastroenterol Hepatol, 2017 Oct;15(10):1604-1611). Getting both obese and normal weight people to lose weight helps them to get fat out of their livers and markedly reduce their chances of being diabetic (European Journal of Gastroenterology and Hepatology, Dec 1, 2021;33(1S Suppl 1):e529-e534). Many people with big bellies and small buttocks are already diabetic and are at significant risk for heart attacks and other side effects of diabetes (Front Nutr, June 9, 2023;10:1173488).

You are likely to have a fatty liver if you can pinch more than two inches of skin and fat next to your belly button, or if you have a big belly and relatively small buttocks. Waist sizes that predict a fatty liver are anything over 81 cm (31.89 inches) in men or 78.5 cm (30.91 inches) in women (Nutrients, 2022 Jul; 14(14): 2994). Your doctor can confirm the diagnosis with a sonogram of your belly that shows a fatty liver.

See Fatty Liver Can Cause Diabetes, Heart Attacks and Cancers

How a Fatty Liver Can Cause Diabetes
A high rise in blood sugar after eating can cause considerable cell damage by causing sugar to stick to the outer membranes of cells and damage them. To prevent blood sugar from rising too high after you eat, your pancreas releases insulin into the bloodstream and insulin lowers blood sugar by driving sugar from your bloodstream into your liver. However, if your liver is full of fat, the liver does not accept the sugar and you become insulin resistant and your blood sugar will rise too high after you eat.

My Recommendations
A person can have a fatty liver, even if they are not overweight and do not appear to be fat. I recommend working to get rid of liver fat by following an anti-inflammatory lifestyle:
• Try to exercise every day
• Eat lots of vegetables, fruits, beans, nuts and other seeds
• Avoid sugar-added drinks (including fruit juices) and foods
• Restrict refined carbohydrates — foods made with flour such as bakery products, pastas, and most dry breakfast cereals
• Restrict or avoid red meat and processed meats
• Avoid smoking and recreational drugs, and restrict or avoid alcohol