Fatty Liver Disease Is a Hazard for Some Eating-Disordered Patients

Prolonged fasting and bingeing are problematic among those with BED.

Nonalcoholic fatty liver disease (NAFLD) is a common condition and, for most people, causes no signs and symptoms and no complications. However, in others, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis. In its most severe form, nonalcoholic fatty liver disease can progress to liver failure. Among people with eating disorders, prolonged fasting and excessive caloric intake, such as during binge eating, can lead to nonalcoholic steatosis.

As reported by Drs. A. M. Strangio and colleagues in a poster session at the 19th European Conference of Psychiatry in Vienna, NAFLD is becoming the most common liver disease worldwide. Dr. Strangio and colleagues at Catholic University of Sacred Heart, Rome, sought to learn if eating disorders are associated with NAFLD and, if so, how to reduce the risks. The researchers used a number of measures to test 78 patients with eating disorders before and after they were treated with a multidisciplinary approach that included behavioral therapy, dietary assessment and treatment. They used the Fatty liver Index (FLI), which is based on values of body mass index, trigylcerides, waist circumference, and gamma-glutamyl-transferase (GGT) to establish risk of fatty liver and then administered the Eating Disorder Inventory and Questionnaire.

Fifty-four percent of patients with binge eating disorder had a greater than 85% risk of NAFLD. The FLI and GGT were significant lower after the patients completed treatment. Four of the 8 subscales of the EDI, drive for thinness, interoceptive awareness, bulimia, and ineffectiveness, improved after multidisciplinary treatment.

The authors noted that the association between NAFLD and eating disorders was clear, and that an interdisciplinary treatment approach reduced the risk of NAFLD in their patient group. They also stressed that while therapy did reduce the risks, patients with eating disorders should be regularly monitored well after treatment ends.