Image: Illustration / Source: Publika.aí Communication
From the Editor
Hepatic steatosis, popularly known as fatty liver, already affects around 30% of the Brazilian population, equivalent to 1 in every 3 Brazilians, according to data from the Brazilian Society of Hepatology (SBH). Despite the high prevalence, 61% of Brazilians have never taken or do not know which tests detect the condition, revealing a scenario of lack of knowledge about a disease that can progress to cirrhosis, liver cancer and the need for transplant.
“Fat liver is a silent epidemic. Most of the time, the patient only discovers the condition when it is already at an advanced stage, with significant involvement of the organ. This happens because, in the initial stages, the disease usually progresses without showing symptoms”, explains Dr. Lucas Nacif, digestive system surgeon, medical director of the Hepatoclin clinic and active member of the Brazilian Association of Organ Transplantation (ABTO).
The warning gains even more strength given the projections about the impact of the disease in the future. According to a recent report by Novo Nordisk, it is estimated that, by 2030, steatohepatitis will become the leading cause of liver transplants.
In Brazil, data from the Brazilian Transplant Registry, Official Vehicle of ABTO, indicate that in 2025 there was a slight increase in the number of procedures performed compared to 2024, but the waiting list is still significant, which highlights a mismatch between donations and demands.
From fat to cirrhosis: understand the progression
The liver gradually accumulates fat, making early diagnosis difficult. “When the patient begins to feel excessive tiredness, weakness or abdominal pain, the disease has generally already progressed”, highlights Dr. Nacif.
Progression follows a predictable path. If not diagnosed and treated, the condition can progress to liver inflammation (steatohepatitis), fibrosis, cirrhosis and even liver cancer.
Risk factors and treatment
Research carried out by Novo Nordisk in partnership with the Datafolha Institute revealed that 66% of Brazilians are overweight or obese, an increase of 11% compared to the previous year. Among the risk factors, diabetes also stands out. When diabetic patients are evaluated by ultrasound for the presence of steatosis, 70% are carriers of the disease.
“Overweight, type 2 diabetes, a sedentary lifestyle and a diet rich in ultra-processed foods create the perfect environment for the accumulation of fat in the liver”, he says.
Abdominal ultrasound is the most accessible test to detect fatty liver and should be performed periodically, especially by people in risk groups. “If identified early, steatosis can be reversed with lifestyle changes”, highlights Dr. Nacif.
Treatment involves a balanced diet, regular physical activity and weight control. According to the expert, most people diagnosed with the disease at an early stage will not develop serious complications if managed properly. Losing 5% to 10% of body weight translates into significant improvements in liver health.
“The key is prevention. Routine exams can save lives by detecting the disease before it causes irreversible damage to the liver”, concludes Dr. Lucas Nacif.