Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD), which affects around 25% of the world’s population, has been rapidly rising along with the rate of obesity in the world. NAFLD is now the leading indicator for liver transplantation in developed countries. NAFLD is a spectrum of diseases ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), which can progress to advanced fibrosis and cirrhosis, eventually culminating in hepatocellular carcinoma. NAFLD management continues to pose challenges for patients, physicians, and healthcare systems because there is presently no approved effective pharmacotherapy. The current standard of care emphasizes intensive lifestyle interventions that include calorie restriction, increased physical activity, and weight loss. Several studies have demonstrated that weight loss of 5% or more of body weight can put NAFLD into remission. However, strict compliance and long-term effort have been an issue for many NAFLD patients precisely because of the difficulty of maintaining a sustained weight reduction. This chapter discusses the evidence supporting lifestyle intervention’s effectiveness in improving NAFLD and the barriers that hinder the implementation of lifestyle adjustments and behavior changes. Finally, a few tips to help overcome these barriers are briefly discussed.