Fatty-Liver Disease Retreats With Weight Loss

If patients lose 9 percent of their body weight, a dangerous condition of the liver can be reversed, a recent study has shown.
   
The condition, known as nonalcoholic steatohepatitis (NASH), is characterized by an abnormal, usually obesity-caused buildup of fat in the liver. This produces inflammation, which damages sensitive liver tissue, resulting in the formation of scar tissue, and eventual liver hardening and impairment of the organ’s function.

The study, published in the journal Hepatology, was conducted at Saint Louis University and Brooke Army Medical Center using the diet drug orlistat (brand names Xenical and Alli). The drug didn’t improve the liver condition by itself. The research was important in that it identified a clear weight-loss goal that could be set before fatty-liver-disease sufferers to help them resolve their illness.
   
“It’s a helpful study, because we can now give patients a benchmark, a line they need to cross, to see improvement,” said Brent Neuschwander-Tetri, a hepatologist at Saint Louis University Liver Center and a study researcher. The researchers’ goal was to determine whether orlistat, which reduces fat absorption in the intestine, plus calorie restriction, would promote weight loss and relieve liver disease in overweight patients with NASH.
   
Fifty patients, who were determined to have NASH by liver biopsies, participated in the study. All were told to eat a 1,400-calorie daily diet plus vitamin E for 36 weeks, with half receiving orlistat, too. At the end of the study, their livers were biopsied again. It was found that patients who lost at least 5 percent of their body weight had less insulin resistance and fat accumulation in their livers. And those who lost 9 percent or more of their weight saw a reversal of their fatty-liver disease.
   
The group taking orlistat, manufactured by Roche Pharmaceuticals, which funded the study, lost an average of 8.3 percent of their body weight, while those in the other group lost 6 percent – not a statistically significant difference. Concerning liver disease, orlistat did not by itself help liver enzymes, insulin resistance or liver damage.

“The bottom line is that weight loss can help improve fatty-liver disease,” said Neuschwander-Tetri, who is a professor of internal medicine at Saint Louis University. “Now we know how much weight loss is needed for improvement, and we can give patients specific goals as they work to improve their health.”

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