TABLE 3.
Effective Measures to Treat NAFLD
| Interventions | Result |
|---|---|
| Motivational interviewing47 | Significantly enhanced weight loss (1.47 kg greater) with motivational interviewing vs control treatment.46 |
| Personalized action plan | Facilitates successful health behavior change,48 particularly when integrating daily routines; adherence increases with patient education,45 peer or social support, and addressing any barriers.51 |
| Daily weighing | Associated with significantly greater weight loss and less weight regain49; up to overall 9% weight loss in 6 months associated with daily weighing vs less than weekly weighing.50 |
| Peer support or telephone coaching | Effective in the Veterans Health Administration for weight loss and glycemic control in patients with diabetes with low health literacy.53,54 |
| Diabetes Prevention Program | Racially diverse patients with prediabetes received a lifestyle-modification program with individualized lessons in diet, moderate exercise, and behavior modification over 16 sessions. This intervention was associated with an average 6% weight loss at 6 months and a 58% decreased progression rate to DM over a 3-year follow-up55 and 27% decrease over a 15-year follow-up.56 |
| Bariatric surgery | Bariatric surgery may be considered in patients with: a) BMI > 40 or b) BMI > 35 with comorbidities (eg, diabetes mellitus, hypertension, sleep apnea, etc).63 in the absence of decompensated cirrhosis64; In the VHA, bariatric surgery yielded 21% sustained weight loss from baseline (vs matched nonsurgical population) at 10 years postoperatively in patients undergoing Roux-en-Y gastric bypass59; Risks include 3% serious complications, 1% reoperation rates,61 and 0.4% 30-day mortality.62 |
| Filtered coffee consumption | Associated with more favorable liver-related outcomes and lower rates of advanced liver fibrosis.65 |
| Mediterranean diet | Reduces liver steatosis.66 |
| Statin use | May improve liver chemistries and fibrosis; can be safely used even in the presence of an elevated ALT.11,67 |
Abbreviations: ALT, alanine aminotransferase; BMI, body mass index.