Q: Can NAFLD occur in Lean people, i.e. persons who are not obese?
A: Yes NAFLD [Fatty Liver] can occur in Lean people, i.e. persons who are not obese.
Q: What proportion of NAFLD patients are lean NAFLD?
A: Upto about one sixth of NAFLD patients may not be obese.
Q: Why does NAFLD [Fatty Liver] occur in Lean people, despite than not being obese?
A: Most of the persons who are not obese and yet have NAFLD are metabolically abnormal. Like overweight or obese NAFLD, they also generally have resistance to action of insulin at different levels inside the body. What this means is that most of them have either central obesity without excess weight [their waist or central part of body at around level of navel is more than normal], or they have lipid abnormalities like high bad cholesterols or low good cholesterol [HDL] and may often have disturbances in their glucose metabolism. Uncommonly this may even be due to certain genetic disorders.
Q: How does one treat NAFLD in patients who are lean?
A: In Lean NAFLD patients who are not obese, unlike obese/overweight NAFLD patients, reduction of weight is not a target for treatment. However these patients should also exercise regularly and avoid fatty food, because this can ameliorate their fatty liver without weight reduction. Besides, other accompaniments like diabetes, high blood pressure and abnormalities of lipids have to be treated appropriately too.
Q: What other precautions are needed for Lean NAFLD patients? A: Lean NAFLD patients should avoid overeating and putting on weight. Besides they should avoid cola drinks in particular. They should not smoke and should not drink too. They should also avoid medications which are harmful to liver, and ideally be vaccinated against Hepatitis B and Hepatitis A.