Fatty Liver Disease (MAFLD)
Overview
Fatty liver (metabolic-dysfunction-associated fatty liver disease) is excess fat accumulation in liver cells, often clustering with obesity, insulin resistance, dyslipidemia, and hypertension. Early disease is often asymptomatic or causes fatigue and right-rib discomfort. TCM groups it under rib pain and liver accumulation, with liver constraint–spleen deficiency, phlegm-damp obstruction, damp-heat binding, and phlegm-stasis patterns. Weight reduction through lifestyle is the most effective first-line measure; liver enzymes and fibrosis must be monitored—supportive care does not replace this.
Pattern differentiation (clinical patterns)
Liver Constraint with Spleen Deficiency
Right-rib distension and dull ache worse with stress, fatigue, poor appetite, bloating, loose stools, pale red tongue thin white coating, wiry moderate pulse.
Soothe the liver and strengthen the spleen.
Phlegm-Damp Obstruction
Obesity with heavy sluggish body, chest/epigastric oppression, sticky mouth, poor appetite, pale enlarged tongue white greasy coating, rolling pulse.
Resolve phlegm and drain dampness; strengthen the spleen.
Damp-Heat Binding
Distending rib pain, bitter sticky mouth, nausea, dark urine, sticky stools, possible jaundice, red tongue yellow greasy coating, wiry rolling rapid pulse.
Clear heat and drain dampness.
Connections
Daily care & prevention
Weight loss is key: losing 5–10% of body weight over 3–6 months markedly improves fatty liver; cut sugary drinks, fructose, refined carbohydrates, and fried food; avoid alcohol and unnecessary supplements/remedies; do ≥150 minutes/week of moderate exercise plus strength training. Monitor liver enzymes, lipids, glucose, and liver ultrasound/FibroScan. Massage Taichong (LR3), Zusanli (ST36), Fenglong (ST40), Yinlingquan (SP9), and Qimen. Do not self-take "liver protectants" or herbal products of uncertain origin.
When to seek medical care
Yellow skin/eyes, dark tea-colored urine, marked abdominal pain, vomiting blood/black stools, altered consciousness, ascites, or edema needs urgent care; persistently elevated liver enzymes, right-upper-quadrant pain, or rapid weight loss require further evaluation for hepatitis, biliary disease, and tumors.