Alcoholic Fatty Liver Disease

Drinking heavily may lead to chronic health issues including heart disease, ulcers, excessive weight gain, and liver damage such as alcoholic fatty liver disease (FLD) and cirrhosis.¹ For many people, FLD is the first sign of a potentially larger problem with this vital organ and could point to signs of alcohol abuse or addiction.

How Does the Liver Process Alcohol?

As the largest visceral organ in your body, the liver helps you digest food, store energy, and eliminate toxins such as alcohol.² A healthy liver can process about one standard drink per hour; in the U.S. this is equivalent to:^3,4

• 12 ounces of beer, or one bottle at 5% alcohol.
• 8 ounces of malt liquor at 7% alcohol.
• 5 ounces of wine at 12% alcohol.
• 1.5 ounces of hard liquor, or one shot, at 40% alcohol.

As the liver breaks down alcohol, it can generate additional toxic substances in the body.² Over time, with excessive alcohol consumption, the cumulative toxicity associated with alcohol can result in liver cell injury, inflammation, and a weakening of your body’s natural defenses.²

What is Fatty Liver Disease?

Fatty liver disease (FLD) develops as fat builds up in your liver.² There are two main types of this condition: nonalcoholic and alcoholic.² The former is not related to heavy alcohol use and results from fat accumulation in the liver with little to no inflammation or liver cell damage.² This is called simple fatty liver and generally doesn’t progress to a point of liver damage.²

Fatty liver can also develop in non-heavy drinkers with concurrent inflammation and liver cell damage; this condition is known as nonalcoholic steatohepatitis, and is associated with progressive scarring of the liver (cirrhosis) and liver cancer.²

Alcoholic steatohepatitis is caused by alcohol abuse and only happens in people who are heavy drinkers and those who have been drinking for a long period of time.² The risk of developing alcoholic fatty liver disease is higher for heavy drinkers who are obese, women, or have certain genetic mutations.²

Alcoholic FLD is usually a silent disease with few or no symptoms. You may feel tired or have some aches in the upper right side of your abdomen if you do feel any symptoms.² This is the earliest stage of alcohol-related liver disease. More severe or progressed forms of alcoholic liver disease include alcoholic hepatitis and cirrhosis.²

If you or a loved one are concerned about FLD or the alcohol misuse associated with the onset of FLD, consider reaching out for help. The content on Alcohol.org is brought to you by American Addiction Centers, a leading national provider of alcoholism treatment. The navigators on the line at  are prepared to talk you through your treatment options.

Quick Facts on Liver Disease in the U.S.

• Up to 50% of cases of end-stage liver disease in Western countries have alcohol as a major factor.⁵
• In the U.S., excessive alcohol consumption remains one of most common causes of both acute and chronic liver disease, and is the third leading preventable cause of death.⁵
• Among alcohol-related deaths in 2006 in the U.S., 13,000 of them were specifically attributed to alcoholic liver disease.⁵
• Some studies of controlled drinking and subsequent liver biopsies suggest that nearly everyone who drinks heavily for 12 weeks will develop fatty liver.⁵
• In the U.S., 4.5 million adults were diagnosed with liver disease in 2018.⁶

Fatty Liver Disease and Alcohol Abuse

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking as 4 or more alcoholic drinks for females and 5 or more alcoholic drinks for males within a couple of hours of each other on at least 1 day in the past month.⁷ Heavy alcohol use is considered binge drinking on 5 or more days in the past month.⁷

Anyone who drinks heavily for months or years puts themselves at risk for alcoholic FLD.² However, the problem can be exacerbated by malnutrition, poor diets (e.g., eating processed foods), limited exercise, and pre-existing health conditions, like high blood pressure, hepatitis C or obesity.²

Fortunately, alcoholic fatty liver is treatable and can be reversed when an individual stops drinking alcohol and makes certain lifestyle changes.⁸ This includes:² 

• Eating a healthy diet of fruits, vegetables and whole grains and limit salt and sugar.
• Get hepatitis A and B as well as flu and pneumococcal disease vaccinations.
• Exercise regularly which can reduce fat in the liver and help you lose weight.
• Abstain from alcohol.

With less severe forms of alcoholic FLD, it may only take two weeks of abstaining from alcohol to undo the damage. However, once you start drinking normally, you’ll be at risk of developing it again.⁸ If you have more advanced liver disease such as alcoholic hepatitis or cirrhosis, it is recommended that you abstain from drinking altogether.⁸

Quitting Alcohol Abuse

For many, quitting alcohol is not as simple as it sounds. According to the National Health Service in the UK, an estimated 70% of people with alcohol-related liver disease suffer from alcohol dependency.⁸ In the U.S., an estimated 14.8 million adults had an alcohol use disorder (AUD) in 2018.⁹ Alcoholism is a chronic relapsing brain disease characterized by loss of control over how much alcohol you consume, a negative emotional state when not drinking and compulsive alcohol use.⁹

Additionally, the American Society of Addiction Medicine (ASAM) explains that alcoholism is a disease and therefore is an involuntary disability.¹⁰ This means that although a person chooses to drink initially, they may no longer have control over their use and the ability to quit on their own. For many, denial is also a fundamental part of the disease, making it harder for them to acknowledge their need for sobriety and treatment.¹⁰

Within individuals who’ve developed significant alcohol dependence or are struggling with an alcohol use disorder (AUD), quitting drinking can not only be difficult but risky to do so cold turkey. Depending on the magnitude of physical dependence, alcohol withdrawal symptoms may occur when a person decides to quit drinking.¹¹ Symptoms of alcohol withdrawal can range from mild to severe and may develop as soon as 8 hours after the last drink.¹¹

As symptoms progress, in more severe cases, individuals may begin to experience impaired attention, visual and/or auditory hallucinations, seizures, or delirium tremens.¹² Because of this, medical supervision  and withdrawal management is advised in order to help you avoid unnecessary discomfort or life-threatening withdrawal complications.

Treatment for Alcoholism

Following successful completion of detox, a rehabilitation program may be recommended to allow further work toward sobriety and recovery. Research has shown that treatment can be very effective in helping individuals maintain a life of sobriety, no matter how grave the problem may seem.¹³

The type of treatment that will be most suitable may be determined by several individual factors such:

• Previous attempts to quit.
• The amount of current alcohol use and corresponding level of physical dependence.
• Co-occurring medical and/or mental health conditions.
• Additional substance use.

Within a comprehensive treatment plan, individuals may experience private and group therapy, family counseling, behavioral therapies, support group meetings, wellness activities, and medication treatments.¹³ Behavioral therapies can help individuals focus on identifying and changing the behaviors that led to addiction in the first place.¹³ 

If you’re ready to seek treatment, American Addiction Centers’ (AAC) admissions navigators are ready to discuss your treatment options today. As parent company to Alcohol.org, AAC works to make recovery accessible to everyone in need.

The cost of a treatment program for alcoholism can vary widely depending on the type of program and your insurance coverage; check your insurance now to see if you’re covered within an AAC facility. Or call our hotline available 24/7 at  your information is kept 100% confidential.

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