Fatty Liver disease in overweight children and adults

Many adults and children are obese, putting them at risk for a fatty liver, the storage of large amounts of fat in liver tissue. This is associated with obesity, diabetes, and high lipid levels. The liver becomes inflamed and cirrhosis could develop. Diet and exercise changes to achieve weight loss will not only halt the progression of fatty liver, but it could even reverse it.
Among children, 10% of all children have fatty liver and more than 95% of them are obese. The risk of fatty liver disease increases in overweight children who do not have a healthy diet and/or do not have access to sports programs and in those who are hispanic or asian.
Many pediatric gastroenterologists feel the definitive diagnosis of fatty liver is best made by a liver biopsy, in addition to the clinical history of the patient. I raise the question as follows: If this is a reversible process with exercise, weight loss, and change in eating patterns- would it be best to first attempt to try to change the eating and exercise patterns of the child before doing a liver biopsy?
As an integrative physician- I would like to know the whole picture of the patients eating habits before doing an invasive procedure as a liver biopsy.


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