Fatty Liver: A Hidden Culprit Behind Abdominal Weight in Women


Have you ever been baffled by sudden abdominal weight gain that seems to have no explanation? You’re not alone. Many women experience this frustrating phenomenon, particularly those aged 35 to 55 who are entering perimenopause or menopause. I don’t understand what is happening to me; nothing changed, yet I keep gaining weight in my belly! – is a concern we hear regularly from women in this age group. Even more perplexing is that this affects women of all body types, including lean women who never had a weight problem.

We’re here to tell you that this weight gain isn’t random—it has a reason, a root cause, and, yes, a solution. While many women attribute it to hormonal changes, the reality is often tied to an underlying metabolic issue that may have been developing for years. During perimenopause, changes in hormone levels can exacerbate metabolic imbalances, leading to noticeable abdominal weight gain, even if your lifestyle habits remain unchanged.

Understanding the intricate metabolic factors driving sudden weight gain during perimenopause is crucial for women to take control of their health and feel empowered.

Understanding Metabolic Health and the Liver’s Role

Metabolic health refers to your body’s ability to efficiently process the energy (calories) derived from your diet. And guess what? Your liver plays a crucial role in orchestrating this process. It serves as the central control hub of your metabolic engine, overseeing the breakdown and utilization of nutrients.

One of the liver’s main tasks is to create triglycerides, which store extra energy the body can’t use immediately. These triglycerides are stored in fat cells in the abdominal area. This thrifty mechanism allows the body to save energy in case of future scarcity. However, if this stored energy isn’t utilized, it can lead to fat accumulation around the abdomen and impact liver function. A sudden increase in abdominal fat, despite no changes in energy intake, physical activity, sleep, or stress levels, suggests that the liver might be struggling to manage increased energy storage. This prompts us to consider the possibility of a fatty liver as a contributing factor to these metabolic changes.

Decoding Fatty Liver and Its Impact on Metabolic Health

So, what exactly is a fatty liver? Simply put, it’s an accumulation of fat in the liver that builds up over time. While excessive alcohol intake can contribute to fatty liver, the majority of cases are caused by metabolic conditions like insulin resistance, obesity, and polycystic ovarian syndrome (PCOS).

Contrary to popular belief, fatty liver isn’t exclusive to overweight individuals. Thin or lean women can also have fatty liver, highlighting the complex interplay of genetics, diet, exercise, and metabolic health.

Fatty liver affects about 25% of adults in the US, but its actual prevalence could be higher since it often goes undetected. Because early-stage fatty liver disease is often without symptoms, you may not realize you have it unless it’s discovered during screening tests conducted for other purposes.

Identifying Fatty Liver: Bloodwork and Imaging Scans

How do you know if you have fatty liver? A fasting bloodwork panel can provide initial clues. Ask for a comprehensive metabolic and lipid panel with insulin added. Look for these functionally optimal results, which demonstrate metabolic health:

  • Liver enzymes ALT and AST below 26
  • Glucose under 90
  • Insulin under 8
  • LDL cholesterol under 100
  • Total cholesterol under 200
  • Triglycerides under 80

If any of your lab values exceed these ranges, it could indicate compromised metabolic health. However, even if your blood work is within normal limits, you could still have a fatty liver. The only definitive way to confirm this is through an imaging scan like an ultrasound or MRI. If you’re dealing with unexplained rapid weight gain, it’s crucial to request both the specified blood work and a scan for an accurate assessment.

Addressing Fatty Liver in Functional Medicine

In conventional medicine, the treatment for fatty liver is weight management. While weight management is also important in a Functional Medicine approach, we are equally concerned with identifying and treating the underlying metabolic dysfunction. Then, weight management becomes notably easier once the root causes are addressed.

It’s possible to reverse a fatty liver in an early stage, known as stage one. Functional Medicine shines in this arena, offering comprehensive and personalized strategies to support liver health effectively. Our approach involves periodic liver cleanse programs, fasting protocols, dietary interventions, and targeted supplements.

We also address other root causes of resistant weight, such as hypothyroidism, inflammation, gut dysbiosis, high cortisol from stress, and poor sleep. All of these factors can influence metabolic health and contribute to weight fluctuations.

Reversing fatty liver and experiencing the positive effects of a well-functioning metabolic engine isn’t an overnight process. Instead, it requires dedication, time, and consistency to witness significant improvements. However, achieving a healthier liver and body is entirely attainable with the right strategies and support from functional medicine.

The Power of Safe and Supervised Cleanses for Liver Health

We highly recommend engaging in a safe and supervised cleanse as part of your liver-health routine. A cleanse involves reducing your intake of toxins and calories while focusing on nutrients that support weight loss and enhance liver function. Fasting is another option as part of a cleanse regimen.

It’s crucial to start with a medically supervised cleanse, especially if you’re new to this practice. This ensures that you receive proper guidance and support throughout the process. Once you’ve completed a supervised cleanse, you can consider repeating it regularly to maintain your results and continue supporting your liver health.

Monitoring your progress is key, and you can track positive outcomes through improvements in weight loss and favorable changes in lab markers. Many individuals also report experiencing benefits such as enhanced mood, increased energy levels, improved skin health, and even better sleep quality as a result of improved liver health.

In our practice, we offer personalized liver cleanse programs year-round. We also have group cleanses, like our 1-2-3 Detox Program in January and Love Your Liver cleanse in April. Contact us to learn more; we’re dedicated to helping women improve their metabolic health. Optimizing metabolic health at any age helps prevent future conditions like type 2 diabetes, cancer, arthritis, heart disease, and dementia. It’s a win for women’s health and longevity!


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Dr. Laura Paris is a Doctor of Acupuncture & Chinese Medicine and Institute for Functional Medicine-certified practitioner who specializes in hormone balance, immune regulation, and metabolic health

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