Americans are overweight and obese in alarming numbers. This leads to several chronic health problems : Diabetes, High Blood Pressure, Heart Disease and Fatty Liver Disease.
Fatty liver occurs when there is accumulation of fat in the liver tissue. This can stay relatively benign but the fat in the liver cells may also give rise to inflammation. Alcohol consumption is a frequent cause but many times it is not due to alcohol. These are Non- Alcoholic Fatty Liver (NAFL) and Non-Alcoholic Steatohepatitis (NASH), which is the inflammatory form. NASH can lead to scarring of the liver, leading to full-blown cirrhosis and, once cirrhosis has been established, to cancer of the liver (Hepatocellular Carcinoma, HCC).
I have been part of several research studies in this arena and am currently working with Altimmune, a biopharmaceutical company active in this arena.
At this point the best way to get rid of fat in the liver and to reverse to process is to lose weight. This is easier said and done. There are a few, not very effective weight loss medications, and they all should be used as part of a comprehensive weight management program. The most effective way to lose weight and to reverse to process leading to cirrhosis is bariatric surgery.
There are newer medications: the injectables Victosa (Luraglutide) and Rybelsus (Semaglutide). These are more effective and Rybelsus can be administered once weekly. They are GLP-1 agonists. Whena GLP-1 agonist is combined in one molecule with a glucagon receptor agonist, even better results might be achievable with fewer side effects. These promising drug candidates are in clinical trials at this time.
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