Get evaluated by a clinician (confirm fatty liver, assess fibrosis risk)
Achieve gradual weight loss if overweight (target 7–10% over time)
Follow a calorie-appropriate diet (create a modest calorie deficit)
Choose a Mediterranean-style eating pattern (vegetables, fruits, legumes, whole grains, nuts, olive oil, fish)
Limit added sugars (especially sugar-sweetened beverages, sweets, desserts)
Reduce refined carbohydrates (white bread, pastries, many snack foods)
Minimize alcohol or avoid alcohol completely
Limit saturated fats and trans fats (fatty/processed meats, butter, full-fat dairy, fried foods)
Increase high-fiber foods (beans, lentils, oats, vegetables, berries)
Include adequate protein (lean poultry, fish, tofu/tempeh, legumes)
Keep sodium moderate and avoid highly processed foods
Exercise regularly (150+ minutes/week of moderate activity plus 2+ days/week of resistance training)
Reduce sedentary time (break up long sitting periods)
If you have diabetes or prediabetes, optimize blood sugar with your care team
If you have high cholesterol or triglycerides, treat them with your care team
Avoid unnecessary supplements; use only if guided by a clinician
Do not start high-dose vitamin E or other liver supplements without medical supervision
Vaccinate for hepatitis A and B if not immune (ask your clinician)
Review medications with your clinician (some drugs can worsen liver tests)
Monitor liver enzymes and metabolic risk factors as advised
Consider referral to a liver specialist if fibrosis risk is high or tests are persistently abnormal
Use noninvasive fibrosis assessment when recommended (e.g., FIB-4, elastography)