Why Do Lifestyle Recommendations Fail in Most Patients with Nonalcoholic Fatty Liver Disease?

Nonalcoholic fatty liver disease has been recognized as a major health burden. The efficacy and safety profile of pharmacotherapy in the treatment of nonalcoholic fatty liver disease remains uncertain; therefore, lifestyle modification is the first line of treatment. Based on available data, patients should optimally achieve at least a 5% to 10% weight reduction for histologic improvement. There is no clear consensus on the optimal diet or exercise regimen. Sustainability of any intervention is key to success; however, compliance has been a major issue in clinical trials. This finding underscores the importance of multidisciplinary strategies to achieve targeted weigh loss.