What We Treat

What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD or fatty liver is a liver disease that happens slowly over time. It starts when fat builds up inside the liver. Over time, too much fat can stay in the liver, causing problems. NAFLD can be mild or severe.

  • In mild cases, children only have fat build-up.
  • In severe cases—also called Non-Alcoholic SteatoHepatitis (NASH)—fat is combined with liver damage (inflammation or irritation) which can cause scar tissue. The scar tissue is called fibrosis. As fibrosis builds up, it may lead to cirrhosis. Cirrhosis occurs when the liver is scarred and stops working properly.

Symptoms include:

  • Fatigue
  • Fluid in the belly or legs
  • Increased liver enzyme levels in your child’s blood
  • Abdominal pain

NAFLD typically begins around the ages of 8 or 9, but has been seen in children as young as 5.

What causes NAFLD?

NAFLD usually occurs in children and teenagers who are overweight or gain too much weight. Most of the time, fatty liver happens with other health problems, such as:

  • Prediabetes, insulin resistance or diabetes
  • High triglycerides—triglycerides are a type of fat found in your blood used for energy
  • Being overweight

Services We Offer

NAFLD can cause serious liver damage, so it is important that your child be carefully diagnosed and treated.

How is NAFLD diagnosed?

  • Blood tests (liver enzymes): to see if there is liver damage and to rule out other causes of your child’s liver problems.
  • Ultrasound or MRI: to look for fat or other abnormalities in the liver.
  • Liver biopsy: may be used for diagnosis.

How is NAFLD treated?

Children with NAFLD can improve with medical care, healthy habits and some medicines. Children benefit the most from losing weight. We encourage children and their families to follow key health behaviors like:

  • Avoiding sugary drinks
  • Drinking lots of water
  • Getting at least 60 minutes of physical activity every day
  • Limiting TV and screen time to one hour or less a day
  • Making half your plate vegetables at mealtimes
  • Eating breakfast everyday

Other activities that can harm the liver should also be avoided, like drinking alcoholic beverages.

Some treatments are available. Studies in teens with NAFLD have shown benefits from the natural form of Vitamin E. There are also new research studies focused on finding medicines to cure NAFLD. Your child’s doctor may recommend a medicine after discussing the risks and benefits.

How can you help your child?

Work together as a family to improve your healthy habits. Small changes can make a big difference over time.

  • Start with one new healthy habit today.
  • Continue to add healthy changes over the coming weeks and months.
  • Work with your child’s doctor to get any tests that are needed.
  • Follow treatment recommendations.

Our Unique Approach


Meet the Team

Meet our pediatric hepatologist

Our team is led by Dr. Miriam Vos, a pediatric hepatologist and national expert in the field of NAFLD. She has been conducting National Institutes of Health (NIH)-sponsored research and providing clinical care for children with NAFLD for more than 10 years.