FATTY LIVER DISEASE
Dr. Ibrahim Hanouneh
Episode #89: January 15th, 2026
in THIS EPISODE
Fatty Liver Disease is an epidemic—1 in 3 people has it and many don’t know they do. Dr. Ibrahim Hanouneh, leading hepatologist and co-author of Skinny Liver and Regenerative Health, tells us what we need to know so we can avoid fatty liver or reverse it.
We track his career from early medical training in Syria and England to cutting-edge work at the Cleveland Clinic. Dr. Hanouneh shares how the liver’s extraordinary ability to regenerate brought him into the study of the liver, then breaks down the progression of liver disease in an accessible—and hopeful—way.
We discuss the critical role of the liver, the metabolic health crisis affecting 90% of people, the root causes of fatty liver in both adults and children, and how the disease is linked to heart attacks and strokes. From there, we cover risk factors we can control, those we can’t, and why women over 40 and adults with obesity, diabetes, and sleep apnea are at particularly high risk.
Dr. Hanouneh explains the non-specific symptoms of “the silent disease,” the five criteria for metabolic syndrome, and how to get tested for fatty liver. He addresses the four metabolic types, why BMI is outdated, and how “skinny fat” is the real medical risk.
Stressing the importance of prevention and early detection, Dr. Hanouneh shares the impact of diet, sleep, and stress, the best exercise to reduce fat in your liver, and proven food and lifestyle strategies. Next up: the common supplements, detox products, and over-the-counter medications that are causing liver damage, and why a daily cup of black coffee may be exactly what you need.
For those diagnosed with liver disease: We get into the latest studies, what we need to know about the two FDA-approved medications, timelines for recovery, and exciting new developments with transplants.
The key takeaway: When you catch it early and make strategic lifestyle changes, fatty liver is 100% reversible. Don’t miss this episode so you know exactly what to do.
TESS'S TAKEAWAYS
Fatty liver has surpassed alcohol as the leading cause of liver disease and liver cancer.
What causes fatty liver is a high intake of carbs and sugar—not necessarily fat.
Type 2 diabetes and fatty liver are linked—having one increases risk for the other.
Sleep apnea and chronic stress both accelerate fatty liver through inflammation.
Children are developing fatty liver due to diet and sugary drinks, obesity, and diabetes.
Fatty Liver was renamed from NAFLD to MASLD to reflect its metabolic origins.
Knowing your metabolic type enables detection and tailored treatment for fatty liver.
Rezdiffra and Wegovy are FDA-approved drugs for treating fatty liver disease.
ABOUT DR. HANOUNEH
Dr. Hanouneh completed his residency in internal medicine and fellowship in gastroenterology and hepatology at the Cleveland Clinic, and served on staff there before attending patients at the Mayo Clinic and joining the Board Of Directors at MNGI Digestive Health.
Co-author of the books Skinny Liver and Regenerative Health, Dr. Hanouneh has spent much of his career working with liver disease, with particular expertise in studies relating to fatty liver. He has presented at national and international conferences, and authored over 70 papers and numerous abstracts.
CONNECT WITH DR. HANOUNEH
