Hormonal

Insulin resistance is a major feature of NAFLD that drives hepatic fat accumulation through increased free fatty acid delivery and stimulation of de novo lipogenesis, and treatments improving insulin sensitivity (weight loss, metformin, thiazolidinediones) show benefit in reducing liver fat.

If you have fatty liver, focusing only on low-fat diets may not be enough. The underlying issue is often how your body handles insulin. Strategies that improve insulin sensitivity, such as weight loss, exercise, or medications like metformin or thiazolidinediones (under doctor supervision), are more likely to reduce liver fat than diet alone.