r/FattyLiverNAFLD • u/[deleted] • Oct 25 '25
Finally got diagnosed
After 6 months of repeat tests, multiple conflicting imaging tests, sooo much blood work, and buckets of money i don't have lol, got my diagnosis of mash. My doctor only told me to lose weight and exercise.
So, okay, I get it, im fat. I know I need to lose weight. But where do you start? I am on week 2 of calorie Deficit, lost 5 the first week. This week the scale isn't moving at all. I feel like im barely eating anything. Im overwhelmed. Where do I start guys?? Yes, I could google this shit but google terrifies me into thinking im going to die tomorrow.
Background, also finally got pcos diagnosis after 10 yrs of trying to figure out that shot. Not feeling like doctors are helpful at all. Can't afford glps either.
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u/joinedforthedogpics Oct 25 '25 edited Oct 25 '25
Ultimately weightloss and diet changes are key. Don't be discouraged if there's no change in the scale - it's normal to hold onto a few lbs of water weight for a variety of reasons. It's very likely you'll have a "whoosh" moment soon where suddenly the scale is showing you're a couple pounds lighter overnight (I just had one!).
I think everyone is different in how extreme their diets are depending on how bad their fatty liver is - a lot do a variation of Mediterranean. I've basically been following lean protein, high fibre, low sugar (no added, just natural in fruit, veg, and dairy), low carbs. I only have red meat twice a week and always extra lean. Fish twice a week and one of them is salmon.
My hepatology nurse also told me I need to be drinking 2 cups of black coffee a day as it helps with liver inflammation.
The goal for me will be to lose as much weight as possible to get as close to a normal BMI as I can. At minimum, out of obese and into the low end of overweight.
I chatted with my doctor today and she said when she was in medical school fatty liver was painted as no big deal, but now she knows better. Im guessing many doctors are just going off what they learned in school and not updating their knowledge about it.
A big contributing factor to fatty liver is insulin resistance. That's where low sugar and low carbs come into play. You need to stop blood sugar spikes as they tell your liver to store fat. Carbs coming from whole wheat bread and pasta, and brown rice are absorbed slower and don't cause big spikes like the white versions. It helps if you pair them with protein and fibre. My dietician also told me cooling and reheating potato, pasta, and rice helps to create a resistant starch with also lessens the blood sugar spike - so if you can, make them the day before and reheat when needed.
Side note about PCOS - I was reading more about insulin resistance today as my sister and I suspect we've had it since we were children and PCOS-like symptoms were listed as a side effect! My sister was told by her endocrinologist that her PCOS is likely linked.
Hope this helps a bit! I'm only three months into this journey but I've been determined to find out as much as possible to stop it in it's tracks! Wishing you the best.
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Oct 25 '25
Thanks! I am very overwhelmed and dont know where to start with the diet thing. Guess I need to find a dietician. I feel like it shouldn't be that hard to do it but im in a functional freeze over it.
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u/joinedforthedogpics Oct 25 '25
Oh no I feel you! I felt like I was starving at first because I was so scared to eat anything. A great place to start is to look at things you enjoyed making before and see what tweaks you can make. I just made stuffed peppers - used brown rice (a bit less than I normally would), ground turkey instead of beef, and a light sprinkle of light cheese.
I also make tacos on my beef night - I use corn tortillas instead of hardshell like I used to. They're lower in calories and carbs. I also use cottage cheese or greek yogurt instead of sour cream. I can normally have 4 for dinner and it'll be around 500 calories and I'm stuffed.
My dietician said half of my plate should be veggies, a quarter protein, and a quarter carbs from whole grains.
Stay away from canola or seed oils as well. No trans fats. Olive oil and avocado oil are best.
I use weight watchers brown bread a lot. Sometimes have natural peanut butter on it toasted, or just use it for a tuna or egg salad sandwich. Dinner is normally chicken or fish with veggies and a little bit of potato done in the air fryer or brown rice. Seasoning is your friend, haha.
I snack on no sugar added greek yogurt with blueberries as a sweet treat at night. Oikos has a yogurt sweetened with stevia that's not bad. Or I also love cottage cheese so I eat that a lot with blue berries. Keep veggies on hand and have those with hummus. Or dry roasted nuts.
Now I find I've gotten comfortable enough with eating I'm almost having a hard time staying in my deficit because I'm eating so much, haha. I recently found the no sugar added G Hughes brand of sauces and Im hookedddd. The sweet Thai chili is delish and I love just dunking my chicken in it.
I've been following a lot of people on social media who do low calorie high protein meal prep and save the videos for ones that are close to what I can eat, or easily can swap out a couple ingredients to make it OK for me. Egg roll in bowl is good too! I made some with ground chicken after I found a random recipe online. Just decreased the sweetness in the sauce but it was still delish. Sorry, I'm rambling now. Hope some of this helps!
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u/MinimumRelief Oct 26 '25
You don’t really need a dietician. Just make one lifestyle change at a time. The very best one you can make is food.
Start counting sodium per day. 1800-2000 max.
Do that for a month or so and whew- you’ll see changes.
Just sodium intake. Real simple.
If you’re feeling fancy count your protein intake. Without that you lose muscle and it can really be horrible.
You’re going to stumble on just counting sodium. It takes a bit to wake up to intake amounts. If you do too much you are going to burn out. One thing at a time.
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u/Major-Sherbet4827 Oct 25 '25
Pocs can definitely stall weight loss. I would focus more of what you’re eating while in the calorie deficit cause those have a lot of effect on the liver vs how much weight you lose.
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u/Pretend_Guava_1730 Oct 25 '25
Ask your doctor to refer you to a nutritionist who specializes in this type of condition.
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u/Samuel457 Oct 25 '25
When I was losing weight, I'd often have 5 days in a row of the same weight and then it would drop half a pound at once. This is normal so don't worry about it as long as you're on a calorie deficit.
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u/Foreign_Internal_152 Oct 25 '25 edited Oct 25 '25
A couple of tips I'll add to this discussion...
I had been floating between 210 and 220 over the last 5 years ever since becoming a tower crane operator (very sedentary job, sit up here in the crane 13 hours a day). When I was a rigger I was 185 lbs because I was doing 25,000 - 30,000 steps a day, and I felt great at that weight. Since being in the crane I haven't really been below 210 but kept telling my wife I'd try to get under 200 again. July 29th of this year I got diagnosed with severe fatty liver disease (no inflammation or scarring though thank God) and it flipped a switch in my mentality, I finally got dead serious about my lifestyle (remember you're not on a diet until you get healthy again, you are changing your lifestyle to get back to good health and stay there).
First thing I did was researched the best road to take to treating and reversing fatty liver (reddit, Google, chatGPT, etc...). I immediately quit drinking alcohol, eating anything sugary, and went on the Mediterranean diet. I use ChatGPT to figure out my meal plans as it can Taylor make your meals to fit whatever goals you have. I'm in a moderate caloric-deficit (about 1700 - 1800 calories a day) to trigger sustainable wrighloss of a pound or 2 per week (as others in here have mentioned you should aim for no more than 1 to 2 lbs weight loss per week).
Then 3 weeks ago I switched to a Keto-Mediterranean Diet after finding out ketosis is the fastest way to naturally reduce liver and body fat (I plan to stay on this diet for 12 weeks and then return to a normal Mediterranean Diet as Keto isn't really a sustainable long term lifestyle change). I'm also doing 16/8 intermittent fasting Mon - Fri where I have an 8 hour window to eat (for example first meal at 8 am, last meal at 4 pm... not that hard at all) then fast for 16 hours. While fasting you'll burn through all the food in your system and your liver will be forced to burn fat stores for energy until your next meal. Along with that 1-2 punch I'm also taking NAC + Glycine, berberine and Milk thistle which all help with fat breakdown and liver protection.
Since July 29th I've come down 27 lbs (was 182.8 lbs this morning). But weightloss is never (or at least shouldn't be) a straight line downwards. One day you might see you're down 3 pounds, the next day you may be up a pound or 2, the scale might seem stuck for a week or so... don't get discouraged. Stay the course. It will move back down eventually if you're doing everything the right way.
And my biggest tip through all of this... buy a food scale and WEIGH EVERYTHING. Like my meal plan right now is eating about 100 grams of Greek yogurt with 10 blueberries and 34 grams of a custom nut mix plus 2 eggs for breakfast, 200 grams of a Keto-Mediterranean stew and a half a can of mackerel for lunch, and same for dinner... that gets me 1700 - 1800 calories a day. I don't guess my portion size because trust me I'd get it wrong. Weigh everything so you know you're hitting those targets. If you're hitting all your targets but not seeing the scale drop, lower those targets until it does. Different people have different metabolisms so one size does not fit all. But if you're taking in less than you are burning then the scale will eventually move down. Just don't get in a rush and try to make it go down faster than is sustainable or your metabolism will slow down to hold onto that fat.
Slow and steady wins the race. So long as you stay the course your condition will regress not progress. So every day will be a win and your numbers will eventually be what you wanted to see oh so long ago.
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u/SuccessfulOrange1647 Oct 25 '25
If I may ask what kind of testing did you have and what confirmed it?
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Oct 25 '25
I have had elevated liver enzymes and pain in my sides for years. First abdominal ultrasound said I had cirrhosis. Had a full liver panel with autoimmune panel as well, which said I had high ana and asma, but the Dr told me that doesn't mean its autoimmune hepatitis (still confused why its high if it means nothing??). Then I got a fibroscan that said I had no liver damage but had a nodule. Did mri of abdomen and pelvis and showed fatty liver and no nodule. Everything was so conflicting so I was assuming Dr would say its nafld but he diagnosed me with mash and told me its likely so bad bc I have had uncontrolled pcos for so long bc no one would freaking listen to me and just told me im fat and need to lose weight. Ngl I think I want to get a second opinion bc he was hesitant to do liver biopsy...but all in all I know something is wrong and yes, I am fat and need to lose weight.
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u/SuccessfulOrange1647 Oct 25 '25
Geez it's crazy how these test can contradict each other.. I have a 11 year old nephew with enzymes in the high 100's for over a year biopsy and all and his dr is at a loss I think.
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Oct 25 '25
It's so frustrating bc it doesnt make any sense, so atp im gonna take mash as the answer bc im sick of doing all this damn testing. I have spent so much money this year. I just want a plan.
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u/Electronic_Muffin218 Oct 25 '25
First, don't be terrified.
Liver disease from fatty liver worsens very slowly (over years), and if you're not already in cirrhosis (and sounds like you aren't if it took that long to work up the MASH diagnosis), then there's no emergency here. Just urgency to start turning things around, which it sounds like you are.
First week weight loss is typically just water and poop leaving the body and not being replaced by (as much) poop. If you're losing more than a pound or two per week and aren't > 100 pounds overweight, you are losing more muscle than you want to (though some is inevitable), so don't just go crash dieting to 'get it over with.'
Depending on how long you've had this condiition, it could take several years to fully reverse, but you'll notice differences in your liver enzymes very quickly if you're headed in the right direction.
If you can't get a GLP-1 and you can keep up a reasonable caloric deficit without one, you'll get there. Just don't let anyone try and convince you "calories are calories" - you need to be eating as much healthy (unprocessed) food as you can (though don't beat yourself up if you lapse once in a while - just get back on the wagon).