A girl was found to have severe fatty liver after losing 20 kilograms, what happened?

Fatty liver is a reversible disease, which can be restored to normal with early diagnosis, timely treatment, and active lifestyle adjustment

Changsha Evening News all-media reporter Yang Yunlong correspondent Ji Na

Recently, the news that "a girl lost 20 kilograms in half a year and was found to have severe fatty liver" attracted the attention of netizens, and the doctor said that it was "hungry". Obviously losing weight and losing body fat, why does it cause fatty liver instead? How do you know if you have fatty liver? What are the health risks caused by fatty liver disease and how to prevent it? Li Jianguo, director and chief physician of the Department of Gastroenterology of Changsha Fourth Hospital, gave a detailed answer.

With a body mass index of 18, he even had fatty liver

Recently, the topic of "Girls lose 20 kilograms in half a year and are found to have severe fatty liver" has been on the hot search, attracting attention. According to reports, a 25-year-old girl in Fujian Province found out that she weighed more than 70 kilograms at the beginning of the year, so she formulated a strict diet plan for herself, eating only vegetables and grains every day, eating milk and eggs once or twice a week, and successfully losing more than 20 kilograms in more than half a year, but was recently diagnosed with severe fatty liver. Doctors said that this was fatty liver caused by excessive dieting "starvation".

It is not uncommon for fatty liver to develop "starvation". 30-year-old Xiaoying, since she successfully tried "dehydration" to lose weight 3 years ago, began to lose weight "without staple food", did not eat staple foods such as rice and noodles, and only chose low-fat marine fish for meat, and blanched vegetables with low oil and water. In August this year, Xiaoying, who had "no leftover meat", received a diagnosis of "moderate fatty liver".

Ms. Li, 28, is also a fatty liver patient, but she weighs only 50 kg and has a BMI (body mass index, body mass index) of only 18. Ms. Li said that she was 165 centimeters tall and had previously weighed 58 kilograms, but she still felt fat and joined the weight loss army. She eats only 2 meals a day, and each meal is basically based on fruits, vegetables, milkshakes, a small amount of meat and eggs. After more than 3 months, she lost 50 kilograms. Subsequently, she developed fatigue and menstrual irregularities. When I went to the hospital for examination, abdominal B ultrasound showed mild fatty liver, and many indicators such as liver function and hormones were also abnormal.

Losing weight and losing fat, why does it cause fatty liver?

The liver of normal people contains a small amount of fat, such as triglycerides, phospholipids, glycolipids and cholesterol, which is generally 3% to 5% of the liver weight, and when the fat exceeds 5%, it is called fatty liver. In general, fat content of more than 5% to 10% of liver weight is considered mild fatty liver disease, fat content of more than 10% to 25% of liver weight is considered moderate fatty liver disease, and fat content of more than 25% of liver weight is considered severe fatty liver disease. In recent years, the incidence of fatty liver disease in China has been increasing, with about 3 million to 5 million people suffering from fatty liver disease in China, and the population is young.

"Rapid weight loss, malnutrition, long-term vegetarianism, etc., are all common causes of fatty liver in thin people." Li Jianguo analyzed that when the human body is in a state of long-term hunger, the body cannot obtain essential energy substances such as glucose and various oxidative enzymes needed for fat burning. In order to make up for the lack of glucose in the body, the body will use the fat and protein stored in other parts to convert it into glucose. These fats and proteins will be converted into calories through the liver, which is a "transit station". As a result, a large amount of fatty acids enter the liver, and the body lacks the enzymes and vitamins necessary for lipid metabolism, resulting in fat retention in the liver, resulting in fatty liver.

At the same time, weight loss leads to insufficient intake of nutrients, which affects the synthesis of protein and phospholipids in the human body, resulting in lipoprotein deficiency. Increased glucocorticoid secretion leads to the release of a large amount of free fat into the bloodstream, which is deposited in the liver beyond the lipoprotein transport capacity, causing dystrophic fatty liver disease.

Therefore, if you want to lose weight if you are overweight, you can't go to the extreme, otherwise it will aggravate the liver damage; Proper dietary control can be carried out, avoiding sugary foods, maintaining a low-sugar, low-fat diet, and reducing the food intake of saturated fatty acids and trans fatty acids.

How do you know if you have fatty liver? Li Jianguo said that the B-ultrasound of physical examination can diagnose whether you have fatty liver. According to the echo changes in the liver, the doctor can determine whether the liver fat content is exceeded, and judge whether it is mild, moderate or severe fatty liver. However, it was not possible to determine whether it was simple fatty liver disease or inflammation. Patients need to do further liver function tests, alanine aminotransferase (ALT) is the most commonly used sensitive indicator, and the abnormality can be basically judged.

If the liver is allowed to "gain weight", liver fibrosis may be irreversible

Li Jianguo said that in many cases, fatty liver does not affect normal life, but fatty liver can be transformed into steatohepatitis, liver fibrosis and even liver cirrhosis, which may eventually lead to liver cancer.

Studies have found that if the liver is allowed to "gain weight", liver fibrosis may be irreversible within 10 years. As the disease progresses, 10% to 40% of simple fatty liver disease (when the amount of fat in the liver is 5% to 10%, there will be a simple "gain weight" phenomenon, that is, only fat accumulation and no other complications) can lead to steatohepatitis, 50% of steatohepatitis can lead to liver fibrosis, 15% to 30% of liver fibrosis can lead to cirrhosis, and 30% to 40% of cirrhosis can lead to liver disease disability and death. It can be said that fatty liver is a disease of "boiled frogs in warm water", which needs to be detected and intervened in time.

In general, fatty liver is a reversible disease that can be restored with early diagnosis and prompt treatment. However, fatty liver is also a progressive disease, and it is relatively difficult to reverse severe fibrosis or even cirrhosis. Just like a car heading for a cliff, if detected and intervened in time and the brakes are pressed, the process can be aborted, and even reversed, restoring the normal liver. Fatty liver disease often has an insidious onset, and it can be asymptomatic or have only atypical symptoms, such as fatigue, postprandial drowsiness, constipation, sleep disturbance, etc. Without active intervention, the "car" will be closer and closer to danger.

Actively adjust your lifestyle to "reverse" fatty liver

Li Jianguo suggested that if fatty liver is found, it can be treated according to the following methods:

Seek medical attention in a timely manner and follow up regularly. When you find that you have fatty liver, it is recommended to find a professional doctor for a comprehensive diagnosis to evaluate the severity of fatty liver, liver damage, and other chronic diseases. Depending on the specific condition, the doctor will give you a treatment plan. If the condition is mild, fatty liver can be diagnosed without medication. Within six months to one year, patients with fatty liver should be re-examined, and if there is no improvement, hepatoprotective drugs should be added.

Eat a reasonable diet and adjust the poor dietary structure. It is recommended to reduce high-fat, high-sugar diets; Avoid fatty meat, abalone, crab roe, shrimp paste, cerebral marrow, fish eggs and other foods with high cholesterol content; Try to drink less liquor and quit smoking; Eat more high-fiber foods such as whole grains and cereals, as well as high-protein and low-fat foods such as skim milk, fish, and shrimp, because protein is like a "porter", which will remove the fat accumulated in the liver in the form of lipoprotein, and promote the repair and regeneration of liver cells.

Moderate aerobic exercise. Such as swimming, jogging, brisk walking, cycling, etc., adhere to a moderate amount of aerobic exercise every day to effectively increase muscle and lose fat.

For patients with simple fatty liver disease, in most cases, it can be reversed by adjusting the diet structure, enhancing exercise, and improving life and rest. When the body has loss of appetite, decreased physical strength, yellowing of the skin, yellowing of the eyes, obvious deepening of urine color, abdominal distension, etc., it indicates that the fatty liver disease is aggravated, and you should go to the hospital in time. (Changsha Evening News)