Your liver is fat

Wheat Belly Blog reader, Denise, posted this question:

My doctor has prescribed a low fat diet due to a barrage of tests that ended up showing I have a very fatty liver. I am overweight, have high blood pressure, IBS and acid reflux. In all the reading I have done on here, I keep seeing to add fats . . . healthy ones . . . to your daily eating. How do I eat these and also stick to a low fat diet to please my doctor? I am 59, female, and really need to try to get healthier.

Thanks, Denise

Sorry, Denise, but it’s not your job to please your doctor. It’s your job to do what’s right for your health. Sadly, your doctor is doing more harm than good.

A low-fat diet CAUSES fatty liver because cutting fat increases carbohydrate intake which, in turn, increases de novo lipogenesis, the conversion of carbohydrates to fats that are deposited in your liver.

In other words, feeding your liver more carbohydrates and less fat encourages the formation of triglycerides, some of which are released into the bloodstream as VLDL (very low-density lipoproteins), the rest of which remain in the liver. Triglycerides are fats, fats are triglycerides. As you eat more “healthy whole grains” and other foods that fit into a low-fat diet, your liver makes more triglycerides, your liver–along with your intestinal tract, pancreas, kidneys, and heart (percardial fat)–accumulates fat, gets larger, increases markers of liver damage like AST and ALT. Over many years, this can lead to cirrhosis, identical to the disease generated by excessive alcohol consumption (alcoholic cirrhosis).

If dietary fat is made of triglycerides, doesn’t this also cause fatty liver? No, because your liver’s capacity to manufacture fats outweighs your ability to consume fat. Fats in the diet do indeed increase triglyceride levels in the blood . . . a little bit. But carbohydrates in the diet increase triglycerides . . . a lot (though the effect is delayed for several hours, sufficient to allow de novo lipogenesis to proceed).

Your doctor prescribed a diet that is not only ineffective, but actually causes the problem it was meant to treat. This is like telling a smoker that he’s short of breath because he doesn’t smoke enough. Or telling an alcoholic that she’s woozy and uncoordinated because she’s not drinking enough bourbon. Your liver is fat because you eat too much fat? Wow.

And the “overweight, high blood pressure, IBS and acid reflux” you’re experiencing is highly likely to be a consequence of our favorite carbohydrate to bash: wheat. Lose the wheat, lose the weight, lose the hypertension, lose the IBS, lose the acid reflux . . . lose the fatty liver.

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100 Responses to Your liver is fat

  1. Sharon says:

    I used to think I didn’t eat as much as my husband in a day’s time — he was a truck driver, 6’4″ and weighs about 180 lbs. I’m 5’6″ and weighed way more than he did and thought I was more active than him. I am so grateful for Wheat Belly and Dr. Davis! I’ve lost 16 lbs since Ash Wednesday, haven’t had any wheat at all. I still enjoy dinner at home with my husband and can eat out now without drooling at the bread on the table. I’m learning what things to eat and what to stay away from. This is such a wonderful life-changing experience! I feel better all over, inside and out! If you haven’t lost any weight, don’t get discouraged! Keep at it – I’ve got some more to lose but now I understand that I have to do this for myself – there’s no magic pill, no special drink, nothing to shake on my foods, that will be a quick fix for me. Although I may not have been eating as much as my husband in a day, I was not eating the right things – a habit I will not go back to! “Wheat Belly” is at my fingertips for whenever I question if I want to eat something I’m not sure about. God bless ya, Dr. Davis!!

    • Dr. Davis says:

      Excellent, Sharon!

      You can see that this is about taking back control over appetite and health after years of being fed half-truths and outright nonsense that booby trapped health. It is truly liberating!

  2. Linda Olson says:

    Isn’t it funny how much power that little metal spring thing (AKA the SCALE) has over us. There are so many other numbers that mean so much more, like HgA1c (diabetes test) going from 6.4 to 5.9, Cholesterol going from 206 to 125, blood pressure going from 140/80 on medication to 106/70 off medication. But I’m with everyone else, I want to see those numbers go down!
    I learned something interesting last week. I have been seeing an integrative physician and his holistic nutritionist. They did testing for other food sensitivities, and I found out that I am sensitive to dairy and eggs, including a major sensitivity to yogurt (which I was eating daily). They said that they see this in about 80% of clients that also need to eliminate gluten/wheat, and that this can stall weight loss also.
    So I’m reminding myself of my successes: I’m off 4 medications (GERD, hypertension and cholesterol meds); my risk for diabetes is much less; I’m off wheat/grains for 4 months, starting to eliminate cheese, yogurt, actually all dairy and eggs from my diet; my arthritis pain is better; my skin is better; I’ve lost 11 inches from my waist; and I HAVE NO FOOD CRAVINGS. I have proved to myself that I am not an un-self disciplined, will-powerless defective person who just can’t say no to the call of donuts, even though it was killing me. I’m now down 12 pounds or so (depending on the day), 8 of which I lost in the first few weeks, which I am very grateful for, but that is not the only thing I’m working towards. I want health that will carry me well into the next 30-40 years of my life (I’m 61 now).
    There are several other factors that go into weight loss that Dr. Davis has mentioned, thyroid being one of them. The other thing that I’m interested in learning more about is what I think Dr. Davis called “leptin insensitivity” (or something like that) in his book. He also mentioned circadian cycle/cortisol disruption in a post recently. All this boils down to sleep, I think. Could poor sleep also be creating problems like stalled weight loss? The body certainly is a very complex thing. Nothing is as simple as “calories in/calories out”!

    • Dr. Davis says:

      Terrific stuff, Linda! The 11 inches lost on the waist is incredible!

      Sleep is indeed a powerful inhibitor of weight loss. It activates “stress hormones” cortisol and adrenaline, both of which screw up insulin and weight loss. Before you resort to fairly exotic testing like salivary cortisols, I would try to get a full night’s sleep at least every other day.

      • Tyrannocaster says:

        For some of us, that is just flat-out easier said than done. I almost NEVER sleep for more than six hours and sometimes get as little as four. This is not because of a busy schedule or job pressure; fact is, I just CAN’T sleep longer. I wake up at about 2-3 AM no matter what, and a cortisol test taken four times in the day reflects this. But nobody (so far) has given me any advice that makes a difference on what to do about it. It doesn’t do any good to tell people to get more sleep when they are already trying. It just makes them feel worse about it. I read a long post on Mark’s Daily Apple where he really yelled at those of us who don’t get enough sleep because “that’s the only thing we will listen to” – and honestly, it pissed me off. I’m trying, dude! It’s not a simple as “Just get more sleep” for many of us. I wish it were. I don’t drink coffee, I follow all the typical advice about how to sleep longer, and none of it makes any difference.

        • Lolly says:

          Tyrannocaster, I don’t know if this will be of any help to you, but because I was sleeping so poorly I started taking 1000 mg of calcium and 500 mg of magnesium at night before going to bed. It has made a huge difference in my ability to stay asleep, as well as giving me a much more restful, deep sleep. It won’t hurt to give it a try. Hope it helps you too.

          • Tyrannocaster says:

            Thanks, Karen, but I’m already doing that. I have tried everything I can find for the sleep issue and so far nothing works.

          • Uncle Roscoe says:

            Tyrannocaster, I think we can both find an explanation here, if not a cure:


            The orexin/hypocretin system goes way back in human evolution. The body has 3 states: Eat, Rest, and Exert. Each of these states requires different combinations of organs and systems.

            The orexin system is centered in the brain’s hypothalamus …..the brain’s chemical control center. The hypothalamus receives signals concerning which state to place the body in. Then the hypothalamus sends signals via the orexin system to individual organs to turn them on or off. Each organ has nerve transduction boundaries which throttle organ function. The orexin nerve endings sit in these transduction boundaries. Orexin nerve endings exude specialized chemicals which alternately enhance or defeat transduction signaling, and thereby control organ function.

            Transduction nerves and orexin nerves function via potassium channels. These potassium channels can be attacked by ingested proteins like the ones in wheat, by nerve viruses like herpes simplex and Epstein Barr, and by the immune system in response to one of these antigens. These attacks can come at either end of the orexin system, at organs or at the hypothalamus.

        • Mike says:


          Perhaps the problem is that you’re trying to do it all in a row:

        • Uncle Roscoe says:

          Tyranocaster, I have some related problems, so I’ve been researching……

          There are two pathways to sleep. I outlined the orexin/hypocretin pathway. The orexin system makes body systems comply with sleep. The other pathway is melatonin. Melatonin causes people to get sleepy. Melatonin is secreted by the pineal gland. The pineal gland lies in the low back center of the brain. Melatonin secretion is heavily related to daylight cycles. Daylight cycles and melatonin release are both throttled by ingestion of lutein and zeaxanthin. Excess blue light is harmful to the eyes. Lutein and zeaxanthin (L and Z) are dyes which line the retina, and block out blue light. L and Z are virtually identical twins. L and Z are polyphenol aldehydes. Lutein tends to have more aldehyde properties, and zeaxanthin tends to have more polyphenol dye properties. Some people collect and use L and Z properly. Some people over-collect L and Z, and some people under-collect them. Some people are intolerant of A and Z. Some intolerant people make antibodies which attack and remove lutein and zeaxanthin. For example 85% of autistic children have antibodies to L and Z. When the body makes antibodies to antigens like L and Z it usually 1) invokes lots of inflammation, and 2) makes antibodies against the affected tissues. The effects of lutein and zeaxanthin are vastly under-studied, but it’s easy to see how the body’s reaction to these chemicals can cause bad sleep disturbances.

          Lutein comprises about 1.5 % of yellow corn and egg yolk, the highest lutein concentrations among all foods:

          Yellow corn and egg yolks make me ill, and leave me awake all night.

          • Tina says:

            Not to sound like I am over simplifying but try yoga. It’s not aa overnight, quickie fix usually but it’s positive effects can be felt after one practice. I teach therapeutic yoga and would recommend a gentle class. I suffered from sleeplessness caused by hormonal fluctuations, medications ,etc. due to treatment for breast cancer. It took several months to get back into a regular sleep rhythm. Yoga really helped me along with lots of prayer. If you don’t have access to yoga teachers try Choose a gentle or restorative practice to get your mind settled. Many hugs to you!!!


  3. NancyMc says:

    @ Tyrannocaster – I feel ya! I literally went 20 years like that, its miserable. I never slept more than 3 hrs in a row, that’s WHEN I could actually sleep. I happened on something a couple years back that has been miraculous for me. I take d-ribose powder at bedtime (1 scoop-5grams) along with 600 mg of magnesium (capsules or liquid, no tablets) and I don’t know why it works exactly, but it does. My husband gets the same result as does everyone I have shared it with. I suspect it relaxes your muscles enough to stay in a deeper sleep. I hope you will try it and get some relief! I get mine from Vitamin Shoppe.
    @ Denise- I am excited to tell you that my husband REVERSED his fatty liver that had actually progressed to cirrhosis. The liver specialist was stunned that he did not drink and had not one risk factor for it. I could not believe it when he was diagnosed and set out to fix it with diet. We had been low fat vegetarians for a couple decades and were still fat and sick. Never felt any better or lost any weight until we began eating healthy animal protein and fat and eliminated grains. There is a definite link to grain (especially wheat) and high fructose corn syrup in liver disease. I researched it thoroughly and after we ate grain free and low carb he lost 85 lbs and his enzymes went to normal, along with causing his BP, AIC, triglicerides and cholesterol returned to normal!!!! I also put him on supplements to heal the liver. It worked! The doc said, I don’t know what you’re doing, but keep doing it! We only eat low starch veggies, meat, coconut and olive oil, berries, a few raw nuts, eggs,Kerrygold butter, a little white cheddar and heavy cream in coffee with stevia. (I CAN’T give up my sweet white coffee, haha) and herbal tea in the evening with stevia (NuNaturals liquid vanilla stevia is the only one we like)
    The difference in how you will feel is phenomenol. The carbs raise your insulin, which in turn raise all your labs and BP.
    Frankly, we paid little or no attention to what the doctor said as they offered no hope. Dr Davis is a rare exception!
    If we had followed their instructions years ago, I believe my husband would have had liver failure by now. Take your health power back! You are your own best advocate ;-)

    • NancyMc says:

      P. S. Dr. Davis- I’ve been posting a while as just “Nancy” ( I’m the one who was grain free for 3 years then fell off the wagon and messed myself up!) but there seems to be more Nancys now so I changed my name to NancyMc !

  4. Karin says:

    I have a subscription on this lady’s YouTube channel. She just announced her bookclub. Guess what book is first on the list?

  5. Nowheatforme says:

    Hi Dr. Davis,

    What are your thoughts regarding coconut palm sugar? Dr. Oz says it doesn’t raise blood sugar levels but we’ve received so much well intentioned bad information over the years that it makes me wonder. We switched to erythritrol several weeks ago but am wondering if it is safe.

    • Dr. Davis says:

      Erythritol is perfectly safe, Nowheat.

      Last I checked, coconut palm sugar was a source of fructose, a common tripping point for many of these “sugar substitutes.”

    • Noel says:

      I just read an interesting article from a cooperative coconut producer regarding coconut palm sugar. While it is lower on the glycemic index than cane sugar, it is still quite high, so the benefits are negligible. However, due to the increased demand created by the “sugar substitute” industry, it is becoming a profitable sideline for coconut producers. As demand for this sugar is increasing, the extraction of the sap is lowering the amount of fruit available from the plant, thereby increasing the cost of coconuts, coconut oil, coconut flour, etc. They also estimate that, if current trends continue, it would take 15-20 years for producers to increase their crop sizes to meet the demands, so we’d better be careful what we ask for.

  6. Karen says:

    I believe a low carb system is healthy, but since those high carb eaters in the Blue Zone live into their 100′s without disability – there must be 2 healthy ways of living. Can you please elaborate on this… Could it merely be that adding flour/sugar is the culprit? Or that combining saturated fat with any sugars is the culprit? I have asked this in a past post – and would really like to know your thoughts on this.

    • Dr. Davis says:


      What is the “Blue Zone”?

      • Karen says:

        Hi Dr. Davis,
        I read the book a long time ago – but don’t eat like it … I prefer your meals. I just want to comprehend WHAT is the differentiating factors for living great low carb for those in the blue zone ( ) and eating low carb?
        Best guess is with saturated fat = MUST AVOID anything sugar like or you balloon up. However, Without saturated fat seems one can eat tons of carbs (unrefined and all natural) and not gain so much weight.
        I wish either you or Dr. Taubes would research this – or someone. I was just curious if you knew or if you would be able to try and figure it out.

  7. Mellinda says:

    Tyronnacaster, what about Melatonin? I started out with the smallest dose: 1 mg. I take it 1/2 hour before bed and sleep very soundly with this small dosage. I suppose if this dosage did not work, I could increase it by taking more, but that has not been the case with me. I also don’t take it every day, maybe a few times a week. Any side effects of Melatonin, Dr Davis?

    • Tyrannocaster says:

      Melatonin hasn’t helped either, unfortunately. Nothing has. I’ve tried every supplement my naturopath could come up with, I’ve tried Earthing (I’m skeptical but I’ll TRY anything once) and that didn’t help, I exercise, and I don’t have job pressures because thanks to the problems caused by wheat I retired about six years ago. But since Halloween, when I dropped wheat, I’ve really made a turnaround in all areas…except for sleep.

      • NancyMc says:

        Tyro- :)
        Did you see what I posted above for sleep? Like you said, you’ll try anything! It makes a world of difference for me. I have gone on and off many times as I just couldn’t believe it was that working so well! It never fails me :)

      • Deb says:

        What made the difference for me was getting my sex hormones right (optimized). They really do make a difference as to the quality and length of sleep.
        I googled sex hormones,sleep and there are good links to read.

  8. Monique DiCarlo says:

    Try Paleo for 30 days and you’ll make your doctor fall of his chair! I agree not to please your doctor, they do not know everything and they are often behind with the latest research, and their training is sponsored by the drug industry. Fat does not make you fat, not enough healthy fat makes you sick! Help yourself, heal yourself, there’s so much great info here! Be well, Mo

  9. Johannah says:

    “The doc said, I don’t know what you’re doing, but keep doing it!” Wasn’t your doctor at all interested in learning anything?

    • NancyMc says:

      Not at all…and when I tried to share that we had both lost weight and improved all health markers on a no grain, low carb diet she just looked down at the chart and changed the subject. But she sure noticed when he gained a few lbs back after we fell off the wheat wagon for a while! That got the typical eat less move more lecture…

  10. barnaby says:

    hi dr. davis—-my husband and i have been on your wheat-free diet for almost a month now. our main goal is for his blood sugars to drop and if we can, eliminate the oral agents his type 2 diabetes requires. we have followed it very closely but he seems to have stagnated in his weight loss after losing only 5 lbs…for me, i didn’t weigh myself before starting but i do feel like my belly has started to shrink. is there any special thing he can do to speed up his weight loss?

    • Dr. Davis says:

      They’re on the right track, eh? Not quite there, but getting close.

      This is no small matter, but the ignorance over why this happens and what to do about it is astounding. My colleagues see this as an opportunity for drugs, when it’s the diet advocated by “official” that is doing it.

  11. Jenn says:

    Dr. Davis,
    Your book has changed my life. I have been gluten/wheat free for 5 weeks now. I’m 5’1 and workout 5-6 days a week and ‘thought” I was eating healthy with lots of ‘whole grains’. I couldnt ever figure out why I couldnt lose anymore weight. When I cut the wheat/gluten out, regardless I only have 5-8lbs to lose, the pounds started moving and oh my gosh, the inches in my waist and hips were amazing. I can’t quit telling everyone about my success. Not to mention, I haven’t had to take the first allergy pill this season as bad as NC pollen is and my moods have improved, not to mention, I’m sleeping so much better now. So thank you!! I’ve already gotten several people reading the book and changing their eating habits as well.

    Lastly, I wanted to tell you that I work at a hospital and just recieved the daily coworker news. Well, today is “Whole Grains Sampling Day”. Nationwide companies, including WalMart, McDonald’s and Auntie Anne’s Pretzels, are promoting whole grain foods and encouraging Americans to add more whole grains to their diets. Isn’t that nice?? Total sarcasm here. If anything I wish I could tell these people really what whole grains do to them. It led me to a website for the whole grains councel and the info on their is mind-boggling wrong. This is why our society is so misled and this is why our country is so overweight and sick with disease. Thanks again, Jennifer

  12. denny says:

    Hi Dr. Davis–Is there anything special you can recommend to increase my weight loss? I am following your plan for diabetics yet don’t seem to be losing pounds. So far it has been about 3 weeks. I am a big guy–over 300–but am surprised that, in the course of the day, I am not starving. Yet, despite eating less, although differently, no weight loss has happened. Do you have any thoughts you can offer me? Some friends of mine have also started within the past 2 weeks and have already seen drops of 10 lbs or so. Help!

  13. Dana says:

    A big deal with non-alcoholic fatty liver disease is that typical sufferers who aren’t alcoholics (which, contrary to conventional wisdom which thankfully is changing, alcoholics are in the minority with NAFLD) is overconsumption of fructose paired with insufficient intake of choline. They’ve been able to *induce* NAFLD in rats following this dietary pattern. They’re seeing the same thing in people.

    Chris Masterjohn says that if you’re eating a high-fat diet you need even more choline than the authorities call for in the typical person’s diet.

    Best dietary sources are beef liver and egg yolk. There are other dietary sources if you just can’t stand liver or can’t tolerate eggs, and you can also supplement, though I’ve heard this is generally discouraged. (While aware of potential risk, I myself am supplementing choline. So far, so good.) Dropping wheat is still a tremendously good idea, but you will also do your body a huge favor avoiding sugar and high-fructose corn syrup. (And agave. And honey. Basically, if it touts itself as a low-glycemic sweetener and it’s not an artificial sweetener, a polyol, or stevia, all that sweet is from fructose–AVOID.) And if you’re going to eat fruit, stick with low-sugar varieties. Berries and melon (possibly excepting watermelon) are good.

    • Dana says:

      Aaand I just tripped over my own fingers and brain with the alcoholics vs. NAFLD thing. GAH.

      …But it was once believed that if you had fatty liver disease, you had a drinking problem, despite protests from most patients that that was not the case. Now it transpires that most of those patients were probably telling the truth (there are always a few alcoholics in denial).

      FYI, if it’s turning up on your labs, you’re probably farther along in the disease process, from everything I’ve read so far. Usually, in the early stages, liver enzymes are normal. Wish MRIs weren’t so expensive, they’d catch it sooner. I just assumed I had it, because while I had normal liver enzymes on my labs, I also have a lot of central obesity.

  14. Rose says:

    Thank you Dr. Davis! After reading a bunch on this subject and me being diabetic and have not been taking care of it until now. I decided to start taking some Milk Thistle and am hoping it will fix the damage that’s been done to it over time. I did some research on the Milk Thistle and decided to start taking it. Only thing the one I got is 1K and it says on the bottle to take it 3x a day. BUT on my research it only says like 500mg a day. So I’m just taking one of the 1K a day. I know since I am also 65 pounds over weight that I have a fatty liver so maybe it will get much healthier soon, between eating the WB way and taking these as well! :-)

  15. Annette says:

    Dr, Davis can wheat be a cause for fatty liver disease, know someone who was just given this diagnosis.

  16. DoragonMama says:

    When I gave up artificial sweeteners and switch to pure stevia (not mixed with anything) my non-alcoholic-fatty-liver disease went away.

  17. LINDA M. DISNEY says:


    • Dr. Davis says:

      Yes, you can. But use less of the coconut flour, e.g., 2 -3 tablespoons.

      • Jo says:

        I agree, tried it only once and the taste is incredibly horrid!!! Coconut flour as a substitute muchhhh better, thank you…