His fatty liver reversed from grade III to grade I, weight went down by 20 kg in 3 months: Lessons from a 35-year-old’s daily regime

WHAT ARE TRIGGERS OF FATTY LIVER?

My young patient had a sedentary job with a work-from-home routine. Compounding his couch woes were a family history of obesity and a very poor diet. He would have no less than three colas a day along with chocolate and ice cream. He couldn’t sleep at nights, binge-watching shows on OTT, saying that was his only leisure time.

Though his liver enzymes like SGOT, SGPT and GGT were elevated, he said his levels had never been this high. That’s because in NAFLD, the fat buildup doesn’t translate to significant liver cell damage in the earlier stages. That’s why we quantify fat through an ultrasound called the FibroScan.

THE REVERSAL MANTRA

My patient began by changing his food, consulting a nutritionist and shifting to a Mediterranean-style diet. He mostly had steamed and grilled food, stopped ordering food or dining outside and gave up sugary beverages, even pre-mixes of tea and coffee. He gave up all forms of processed and packaged foods though ready-to-eat pouches were his favourite once. He drastically cut down the carbohydrate content in his meals, increased lean protein, fibre-rich fruits, vegetables, included whole grains and healthy fats. Snacking was only about having fibre. He made sure to have his last meal by 6 pm, come what may. He disconnected himself from his phone by 10 pm and slept by 10.30 pm.

THE WEIGHT LOSS THAT MATTERED

Losing 10 per cent of your current body weight can dramatically decrease the amount of fat in the liver. My patient began slow and steady, attempting 30-minute walks, then going up to an hour. Then he took up weight training and cardio alternating them over six days.

He took up HIIT (High-Intensity Interval Training), like push-ups, squats and burpees, which are very effective in burning fat, including liver fat. He added stress management techniques like meditation, deep breathing and took up pottery as a hobby.

Most important, he kept his changes gradual to prevent negative side effects from rapid changes.

WHAT ABOUT MEDICATION?

We gave him saroglitazar, which is not a cure but can reduce liver stiffness, improve liver enzymes and decrease liver fat content. We supported that with Vitamin E and Omega 3 fatty acid supplements. But in the end, he amended the basic tenets of his life and felt restored and confident.

(Dr Tickoo is Director, Internal Medicine, Max Healthcare)