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‘The risk factors essentially revolve around obesity,’ says Dr Ashley Brown, a liver specialist at St Mary’s Hospital in West London.

‘It’s a bit like pate de foie gras — which is made by force-feeding geese, making their livers swell. A similar thing happens in people.’

As we put on weight, our bodies become less sensitive to insulin. Insulin helps store sugar in the cells but if it is less effective, the sugar gets stored as fat in the liver.

‘This causes inflammation in the same way as too much alcohol does,’ says Dr Brown.

‘Over years this can lead to scarring, and that  can lead to cirrhosis.’

As a result, the normally smooth liver becomes full of nodules and hard gristle, meaning it cannot function as normal.

This can have a profound effect, for not only is the liver vital for processing digested food, it clears the body of infections and helps neutralise toxins and drugs. So cirrhosis can be life-threatening.

And, as the British Liver Trust warns, obesity — not alcohol — will become the main cause of liver cirrhosis if current trends continue.
Obesity - not alcohol - will become the main cause of liver cirrhosis

Obesity - not alcohol - will become the main cause of liver cirrhosis

It’s not just cirrhosis: non-alcoholic disease can lead to liver cancer, stroke and other cancers, too.

It’s estimated more than half-a-million people in the UK could soon have non-alcoholic liver disease, although Dr Brown says it may be much more, as it is ‘significantly under-diagnosed’.

In the past ten years the number of hospital admissions has more than doubled to nearly 2,000, and already it causes almost 700 deaths a year.

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Yet while drinkers know they’re putting their livers at risk, those who are overweight don’t, and because the disease is silent with no obvious symptoms, it can go undetected until it is too late. It is usually spotted by chance when people are in their 40s and 50s.

‘Normally it gets picked up when someone is having a general health screening or blood test for another condition,’ says Dr Brown.

It is diagnosed with blood tests to check the levels of enzymes that can indicate inflammation. Scans or even a liver biopsy may also be done.

Often it causes no symptoms other than mild tiredness, says Dr Brown.

‘Whereas heart problems might lead to breathlessness, for example, the liver is like a plodding donkey that carries on without any complaint — until it is too late.

‘And GPs and the public are not particularly switched on about it, as it was only first described about 15 years ago.

‘I work in A&E, too, and I see people whose liver disease has not been picked up who are now in liver failure.

'Or they are referred to me with late-stage liver cancer, and this is the first they have known of their liver disease.’

Tony, from Dartford in Kent, knows he is lucky to have been diagnosed when he was.

‘I’d had a pain in my toe for a while and decided to use the private health cover I get at work,’ he says.

‘I didn’t even know my liver function was being tested, and when the doctor said “one of your liver function tests is not right” I didn’t really take it seriously.’

Soon after, in May 2011, he had more blood tests and an ultrasound.

‘I went back for  the results a few days later, and the doctor read me the riot act,’ says Tony.

‘He said my liver was suffering as a direct result of my weight. I had a BMI of about 30, putting me in the obese category.

‘What the doctor said made me realise it was time to do something.’

The good news is that a fatty liver is treatable, says Dr Brown.

‘If you start to lose weight and exercise then the liver can start to heal and the fibrosis or scarring will be broken down faster than it is produced.’

Sometimes weight-control drugs such as orlistat (which reduces the amount of fat the body absorbs) may help. Scientists are also developing ‘anti-fibrotic’ drugs to stop the liver scarring, but these are in the early stages.

After his diagnosis Tony cut out cake, biscuits and foods that quickly break down into sugars, such as white bread, and had brown or wholemeal alternatives.

He went to the gym more regularly and stopped drinking completely for three months. When he next saw his specialist six months later, he had lost more than 1½ stone.

‘This time the tests showed that my liver was fine,’ he says. -- http://www.dailymail.co.uk/health/

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