Patient with Severe Fatty Liver Disease at 20 Years Old

Patient N.D.H (20 years old, Ha Dong, Hanoi) visited the 103 Military Hospital due to loss of appetite and fatigue. The ultrasound results surprised the doctors, showing severe fatty liver disease with signs of cirrhosis. The patient himself did not think he was facing such a serious health problem. Afterward, patient H was transferred to the 108 Central Military Hospital for further examination.

According to Associate Professor Dr. Nguyen Anh Tuan, Head of the Department of Gastrointestinal Surgery at the 108 Central Military Hospital, the results showed that the entire liver was covered in fat along with cirrhosis caused by obesity. The patient’s liver function had declined and had aged like that of an elderly person.

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Upon taking a detailed medical history, doctors discovered that since childhood, the patient had been overweight and enjoyed drinking soft drinks and eating fast food. The young man said he could finish a 1.5-liter bottle of soda in a single day instead of drinking water. This habit of consuming soda and fast food made it impossible for H to control his weight, leading to being overweight and obese. In fact, soft drinks and fast food are favorites among many young people.

The doctors advised patient H to lose weight, change his diet, and undergo medical treatment. If the patient does not respond to medical therapy, the doctors plan to reduce obesity through gastric sleeve surgery.

Signs of Fatty Liver Disease


A healthy liver contains about 2–4% fat, which is considered safe. Fatty liver disease often shows no obvious symptoms and is usually detected during routine health check-ups.

In the early stages, fatty liver disease often has no external signs and can only be detected through abdominal ultrasound.

In stage 2, fat accounts for 10–20% of the liver’s weight. At this point, patients may experience loss of appetite, indigestion, bloating, fatigue, and occasional nausea.

In stage 3, when fat makes up one-third of the liver’s weight, symptoms become more evident, such as yellowing of the eyes and skin (jaundice), pain in the right upper abdomen, weight loss, and the appearance of spider angiomas on the skin. At this stage, treatment is only aimed at alleviating symptoms and preventing complications such as chronic hepatitis, cirrhosis, and liver cancer, but the disease cannot be fully cured.

For patient H, who already has both fatty liver and cirrhosis, the condition could progress to liver cancer if not treated aggressively.

The timeline for developing liver cancer depends on the severity of liver damage, body weight, diet, and overall health condition. Weight loss can help reduce fat accumulation in the liver but cannot fully reverse cirrhosis.

Statistics show that 10–25% of patients with fatty liver disease may develop cirrhosis, and about 4% may develop liver cancer. Studies in Vietnam reveal that about 75% of obese individuals and those with type 2 diabetes suffer from fatty liver disease. Previously, the disease was mostly found in older adults, but now it affects much younger people, with some children as young as 10 years old already being diagnosed.

According to Dr. Tuan, to prevent fatty liver disease, people should maintain a healthy diet, limit fried foods and sugary drinks. Additionally, it is important to eat fiber-rich foods such as vegetables, tubers, and fruits; reduce animal protein from meat and replace it with shrimp, crab, and fish; and eat regularly and on time.

People with fatty liver disease should prioritize liver-friendly foods such as turmeric, lemon, apple cider vinegar, green tea, and papaya. Maintaining a healthy weight also reduces the risk of fatty liver disease. Regular health check-ups are essential to detect liver abnormalities early.