Does fatty liver influence personality traits? Research explains its psychological effects

Fatty liver disease is one of the fastest-rising health challenges worldwide, with the American Liver Foundation estimating that nearly 100 million people in the United States live with non-alcoholic fatty liver disease (NAFLD). Often linked to lifestyle factors such as poor diet, obesity, and lack of exercise, the condition can remain silent for years before progressing to cirrhosis, liver failure, or even liver cancer. While the physical risks are well-documented, new research suggests the impact of NAFLD may extend beyond the liver—potentially influencing personality traits.

Distinguishing AFLD and NAFLD

Doctors classify fatty liver into two main forms: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD), also known as metabolic dysfunction-associated steatotic liver disease (MASLD). AFLD results directly from heavy alcohol use, which produces toxic by-products that damage liver cells and accelerate scarring. According to WebMD, abstaining from alcohol at early stages can reverse much of this damage.

NAFLD, by contrast, is not alcohol-related and is strongly tied to obesity, type 2 diabetes, insulin resistance, and high cholesterol. This type often develops silently and can worsen into metabolic dysfunction-associated steatohepatitis (MASH), which involves inflammation and long-term liver cell injury. WebMD notes that about one in five people with NAFLD progress to MASH, which carries a high risk of cirrhosis and cancer.

Personality disorders linked to NAFLD

A recent study conducted by researchers at the University of Birmingham, published in BMC Gastroenterology, found that individuals with NAFLD were around three times more likely to suffer from personality disorders than those without the condition. The researchers pointed out that this association was specific to NAFLD and not seen in other types of liver disease. They also highlighted that depression and anxiety—although common in chronic liver illness—did not show a significant difference between the study groups.

Dr. Jonathan Catling, a co-author of the study, explained that this finding emphasizes the need to screen NAFLD patients for personality disorders, as addressing these psychological aspects may improve patients’ willingness and ability to adopt necessary lifestyle changes such as diet and exercise.

Barriers to lifestyle change

Managing NAFLD primarily relies on weight control, dietary adjustments, and regular physical activity. However, researchers noted that patients often struggle to maintain these changes, partly due to uncontrolled eating behaviors and their outlook on personal control over health outcomes. Those with a stronger sense of internal control were observed to be more likely to succeed in weight loss and disease management.

Prevention and management
While both AFLD and NAFLD can lead to severe complications, prevention is possible. For AFLD, abstinence from alcohol remains the cornerstone of recovery. For NAFLD, lifestyle modifications play a critical role—particularly a balanced diet, physical activity, and management of conditions such as diabetes and high cholesterol. WebMD also points to evidence that a Mediterranean-style diet, reduced sugar intake, and supportive measures like coffee or vitamin E may aid liver health.