Reversing Liver Disease: What Really Works

Most people don’t think much about their liver—until something goes wrong. But for Dr. Supriya Joshi, hepatologist and gastroenterologist, prevention is the priority.

“I’m actually a big advocate of prevention,” she says. “My goal is that people will not develop metabolic liver disease or its other related conditions like prediabetes, type 2 diabetes, high triglycerides, or even obesity.”

Liver disease tied to obesity—now known as MASLD—is on the rise. “Most people with obesity, more than 90%, will also have liver fat or fatty liver,” Dr. Joshi explains. “It’s the most common liver disease associated with obesity.”

For those already living with risk factors like elevated weight, blood pressure, or triglycerides, Dr. Joshi recommends starting with lifestyle. “Paying attention to their lifestyle is the number one thing people can do,” she says, because those changes offer “long-term benefits.”

She recommends cutting back on sugar, refined carbs, and foods with high fructose corn syrup. Instead, she suggests prioritizing protein, vegetables, and fiber. “That will fill the stomach, make people feel more satiated, and even stabilize post-meal blood sugar spikes,” she says.

Even simple changes like walking more can help. “There’s great data to show that walking after a meal can stabilize those post-meal blood sugars,” she notes. And strength training matters too: “Our muscles are an organ of glucose and insulin metabolism… so purposely strengthening the muscle at least three times a week is an important thing as well.”

When it comes to weight loss, even small changes can make a big difference. “Data shows that people can achieve at least 5 to 7% weight loss—they can actually resolve the liver fat,” Dr. Joshi says. And for those with fibrosis? “Weight loss of 10% can reverse it. So it’s exciting.”

For people who struggle to lose weight on their own, she points to obesity medications as an important tool. “The data has shown that along with lifestyle change, people can lose a significant amount of weight and keep it off,” she says. For more about the treatments now available for obesity, click here. 

While some may not reach their ideal goal, she encourages a broader view: “If they’re metabolically healthier, I think that should be the goal… what’s called their new best weight.”

And for those considering supplements or detoxes? Dr. Joshi has a word of caution. “There is nothing you can purchase or consume that will magically detoxify your liver. There is no such thing,” she says. The real detox, she notes, comes from clean eating, physical activity, and reducing alcohol.

As for alcohol itself? “We’re now learning… alcohol is a toxin. It’s toxic to the liver, but it’s also toxic to many other cells in our other organs of the body,” she says. Even low levels may raise cancer risk, and for those with fatty liver, minimizing alcohol is essential.

What’s the number one thing she wishes people knew about liver health and obesity? “It doesn’t have to be their destiny. Change is possible, and reversing both issues is possible,” she says. “What improves obesity can also improve fatty liver.”

An important step towards better health for many people is reaching a healthier weight, which can reduce the risk of cardiovascular disease. To find a physician near you who specializes in weight management, click here.

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This article was sponsored by Novo Nordisk Canada. All content is created independently by My Heart – What To Know with no influence from Novo Nordisk.