A “fatty liver”, also known as nonalcoholic fatty liver disease (NAFLD) or worse, nonalcoholic steatohepatitis (NASH), was first described in 1980 by doctors at the Mayo Clinic. It is an inflammatory disorder which can lead to liver fibrosis, cirrhosis, end stage liver disease and liver cancer. Indeed, this condition is becoming increasingly common and it is estimated that greater than 30% of adults could be affected. 
In general, risk increases for those who abuse alcohol (as in steatohepatitis), are obese, or have some form of metabolic syndrome as a precursor for diabetes and cardiovascular disease (as in NAFLD or NASH).
A recent article by Jiang and Torok investigated the close association of NAFLD with obesity and metabolic syndrome, implicating a dysfunction in the way fatty acids are metabolized and stored (Metabolic Syndrome and Related Disorders, Vol.6, No.1, 2008). In this article, the authors also outlined how inflammation from oxidative stress, and signaling messengers released from fat cells contribute to the development of this condition.
Essential considerations for the prevention and management of this condition are therapeutic lifestyle changes promoted by the National Institute of Health, the American Heart Association and the American Diabetes Association among others. These organizations stress lifestyle changes as the first line of treatment before drugs are prescribed. Lifestyle modifications include regular exercise and healthy eating habits such as eating whole unprocessed foods low in saturated fat. While these are fundamental, herbs such as milk thistle and dandelion root are protective as well as restorative for the liver, while choline and inositol are excellent lipotrophic factors which function to optimize the metabolism of fats in the liver.
As always, if you or a loved one have recently been diagnosed with NAFLD or NASH, or are compromised by metabolic syndrome, diabetes or obesity, contact your healthcare provider for more information regarding treatment options.
