Fatty liver disease is a serious condition caused by stress placed on the liver from excess body weight. People with obesity, diabetes, high blood pressure, and high lipids are at high risk of developing fatty liver disease. Currently, weight loss of 7 to 10% has been shown to be the most effective way of improving fatty liver disease. Patients in our program lose weight safely and effectively through a combination of medications, endoscopic weight loss, bariatric surgery, and therapies. The Yale Medicine Fatty Liver Disease program provides a comprehensive suite of services to help manage the condition. These include: Medications: At Yale, many clinical trials are underway to test the ability of new drugs to treat fatty liver disease. Drugs under development seek to reverse the increased fat in liver cells (and the resulting inflammation and scarring), as well as the increased risk of liver cancer. Medical Weight Loss: Most weight loss medications are tablets that work by reducing appetite. Other medications mimic hormones that the body makes, and improve the body’s ability to manage extra calories. We also offer the OPTIFAST® program, which is a medically monitored weight management program that allows the patient, under the supervision of a physician, to consume a low-calorie diet and receive comprehensive lifestyle education. The typical OPTIFAST patient loses between 30 to 60 pounds in 18 to 24 weeks, and experiences a healthy decrease in blood pressure and cholesterol levels. Additionally, in clinical studies of the OPTIFAST program, about half of the people assessed had maintained enough weight loss for five years to improve their long-term health. Bariatric Surgery: Bariatric surgery is the most effective way to treat fatty liver disease, with improvement in approximately 90% of patients. Bariatric surgery can improve hepatic fibrosis and may reduce the risk of liver cancer. If patients have a body mass index (BMI) above 35, and they have fatty liver disease, they may qualify for bariatric surgery. Patients who are referred to our program will first undergo blood tests and imaging to determine whether or not they have NAFLD (nonalcoholic fatty liver disease) or NASH (nonalcoholic steatohepatitis). Once the diagnosis has been made, we will determine how serious the condition is, which helps our team develop a personalized treatment plan. We take a comprehensive approach to managing fatty liver disease—from medications to bariatric surgery—and refer severe cases to the liver cancer tumor board, if necessary.

Our hepatologists, or those who specialize in treating disorders of the liver, gallbladder, and bile ducts, are highly trained and equipped to treat acute or chronic liver disease. Our doctors are able to provide answers to patients with acute or chronic liver disease, from initial evaluation to management of difficult and complex disease. Our special services include: Diagnosis and treatment of complex liver disorders, including cholestasis, autoimmune diseases, and metabolic diseases (such as Wilson's Disease, hemochromatosis, and alpha-1 antitrypsin deficiency) Liver biopsy, large volume paracentesis, infusions, invasive measurement of portal pressure, endoscopic treatment of variceal bleeding, and Transjugular Intrahepatic Portosystemic Shunts (TIPS) Nutrition evaluation and treatment Management of chronic liver disease and cirrhosis Inpatient treatment of decompensated liver cirrhosis and acute liver failure Our primary clinical programs are: The Viral Hepatitis Program provides state-of-the-art therapy for patients with Hepatitis B and Hepatitis C infections. The Steatohepatitis Program specializes in nonalcoholic steatohepatitis (NASH), a liver disease that is related to fatty liver that is becoming more common. It is associated with a number of metabolic disorders, including diabetes and obesity. The Liver Cirrhosis Program periodically monitors patients for the development of cirrhosis, in which scar tissue replaces healthy liver tissue. The Liver Cancer Program features a team of specialists, from transplant surgeons to medical oncologists, who work together to find the best treatment in order to preserve liver function and monitor for possible recurrence of the cancer. The Liver Transplant Program offers comprehensive care to patients who need living or deceased donor transplantation. Liver transplantation is the cure for many acute and chronic liver diseases.

Our multidisciplinary group of physicians and health providers are committed to providing state-of-the-art therapy to our patients with hepatitis B and hepatitis C infections. We have a 50-year tradition of excellence in liver research and patient care, and continue to be international leaders on the study and treatment of liver disorders. As a partner of the Yale School of Medicine Liver Center, one of only four liver research centers in the country sponsored by the National Institutes of Health, ours is the premier program in Connecticut offering comprehensive patient care for individuals with viral hepatitis. The key to effective disease management of acute and chronic viral hepatitis is our coordinated care among specially trained physicians, as well as a specialized nurse who provides teaching and psychological support. We enjoy close relationships with specialists in adult and pediatric gastroenterology, transplant hepatology, medical and transplant nephrology, transplant surgery, gastrointestinal pathology, diagnostic and interventional radiology, gastrointestinal surgery, rheumatology, OB/GYN, medical and surgical oncology, infectious diseases, the AIDS Care Program, psychiatry, and addiction medicine. The Gastrointestinal Pathology program at Yale is the only subspecialty program of its kind in Connecticut, and provides expert consultative services for the most challenging liver pathology examinations in the region. We partner with Yale New Haven Hospital’s Nathan Smith Clinic in the management of patients with HBV/HIV and HCV/HIV co-infections, and with the Yale Liver Transplant Program in the pre- and post-transplant evaluation and management of patients with liver cirrhosis and end-stage liver disease. We have four areas aimed at improving treatment and outcomes for viral hepatitis: Education: Providing formal education classes and individualized instruction sessions for patients with chronic hepatitis C infection prior to the initiation of antiviral therapy Treatment: Maintaining high standards of practice in treatment protocols and close coordination of care with referring physicians to provide the most advanced and scientifically based approaches to the management of viral hepatitis Research: Ensuring the opportunity for patient access to novel approaches in the treatment of viral hepatitis and liver disorders through clinical trials Community outreach: Building relationships with the surrounding communities of Greater New Haven and Connecticut to raise awareness about viral hepatitis, and to promote screening and education Special services offered by the Yale Viral Hepatitis Program include: Weekly multidisciplinary patient care conferences and liver pathology conferences to draw upon the varied expertise of our Yale Medicine physicians Coordination with the liver and kidney transplant programs Comprehensive services for diagnostic and interventional GI endoscopy, percutaneous and trans-jugular liver biopsy, paracentesis and trans