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 He addresses the four metabolic types, why BMI is outdated, and how “skinny fat” is the real medical risk.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. IBRAHIM 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

Website: https://www.mngi.com/provider/ibrahim-hanouneh-md

Skinny Liver book: https://www.amazon.com/Skinny-Liver-Program-Prevent-Epidemic-Fatty/dp/0738234648/

Regenerative Health book:

Want to lose weight but don’t know whether a GLP-1 medication is right for you? Ashley Koff, dietitian and author of Your Best Shot, explains the links between gut health, blood sugar, hormones, and metabolism, and how we can achieve and maintain our goal weight, with or without the Shot.

We start with Ashley’s own struggle with weight, from belly awareness as a kid and dieting in high school and college, to obsessive exercise, extreme fads, and even a goat’s-milk cleanse! Finally, a gastroenterologist provided a real solution: First, focus on digestion. The results were life-changing. Ashley became a dietitian, building on that approach. She recognized, before the GLP-1s came along, the impact of weight-health hormones—"the Switch"—on blood sugar and appetite, and the connection between these hormones and gut health. She fine-tuned her system, and treated patients with huge success.

From there she walks us through the science—the difference between the Switch and GLP-1 medications that replace these hormones, ”The Shot.” We weigh the benefits and side effects of medications, and how to titrate off them and maintain your results. Covering what you need to know to establish and maintain a healthy weight, Ashley says it's not just about losing weight, it's about optimizing your weight health.

What's “Your Best Shot”? Assess and decode your body’s signals, then create a personalized action plan to fit your specific situation and needs. We talk through that process and what a plan might look like, common pitfalls in formulating a strategy, the skinny on supplements, and why doctors are not always the best guides.

The great news: You can control your weight health more than you think.

TESS’S TAKEAWAYS

1. Your body is an ecosystem, and needs optimized resources to run better.
2. To optimize weight health start with improving digestion and gut health.
3. The body produces hormones that act as “the Switch” to regulate appetite and blood sugar.
4. GLP-1s can reduce food noise, regulate blood sugar, and support weight loss.
5. GLP-1 medications are a hormone-replacement therapy—and suppress the Switch.
6. The medications also can cause dehydration, digestive problems, and other health issues.
7. Titrating off a GLP-1 medication without improving digestion can result in rebound weight gain.
8. Willpower is a fake muscle that does not play a role in effective weight management.

ABOUT ASHLEY

Author of Your Best Shot, Ashley Koff, RD is the founder of The Better Nutrition Program (BNP), the Nutrition Course Director for UC Irvine’s Susan Samueli Integrative Health Institute's Integrative and Functional Medicine Fellowship. Also a faculty member at the Integrative and Functional Nutrition Academy, she teaches the IFNA course “An Integrative and Functional Nutrition Approach to Obesity and Weight Management.”

A go-to nutrition expert on the Today Show, Good Morning America, and others, Ashley was among CNN’s Top 100 Health Makers, InStyle magazine’s Hollywood Nutritionist, and a Global Wellness Ambassador for Westin Hotels.

As a practitioner and business owner, Ashley makes her mission providing personalized nutrition solutions and helping people identify their needs to make “better, not perfect” choices toward their...

Ladies: Tap into the power of other women to get where you want to go. My friends and colleagues Mia Moran, Julie Hannon, and Kelly Lubeck—all members of Skinny60® and the FLOW365 community—join me to talk about what happens when women express themselves freely, and celebrate themselves and each other.

Mia, Julie, and Kelly share their healing journeys, and the profound impact nutrition has had on their personal growth and transformation. They take us inside how they use that knowledge and experience in their private practices, and together, to guide and champion other women.

Starting with support and accountability, we get into why private and group coaching can help us see ourselves with more confidence and resilience. And we discuss the importance of leaders maintaining self-care and awareness practices to create safe spaces and meet clients with clarity and integrity.

We explore the challenges women face today, what keeps most of us stuck, and what we can do to leverage our femininity to make choices that align with what we want. By moving the conversation from our heads to our hearts, making a plan and executing it—with guidance—we reduce overwhelm, and can navigate the complexities of life with balance and ease.

Don’t do it alone. When women come together with a vision, they change the world.

TESS’S TAKEAWAYS:

1. Coach and client engage in a dynamic of co-creation and drive thoughts into action.
2. Great coaches create listening containers that help us approach ourselves in new ways.
3. To walk the talk, ethical wellness practitioners maintain self-care practices.
4. Women need each other. Seek out communities. Tap into the power of the feminine collective.
5. Acting in a community activates the parasympathetic nervous system, for more connection.
6. Titration—making key changes slowly—creates safety in doing things that are hard or scary.
7. Befriending resistance is the path to getting past it.
8. You wouldn’t have an idea if you didn't have the capacity to make it happen.

MEET OUR GUESTS

MIA MORAN

Mia Moran is a mom, productivity coach, and planning expert. She is the host of the Plan Simple podcast, author of Plan Simple Meals, and creator of the FLOW365 program. Her belief in the power of wellness and a good plan got its start during a health crisis. Making changes to her diet, she experienced the impact better nutrition had on her work, relationships, and family life. While operating her design business, she began creating and sharing content around food, wellness, spirituality, motherhood, and feminine productivity. Her content resonated with other women. Mia has struck her perfect balance between wellness, work, and family; and she helps busy women and female entrepreneurs reduce overwhelm, find balance, and make strategic plans that enable them to achieve their goals.

JULIE HANNON

As a shamanic healer, energy medicine teacher, and yoga practitioner, Julie Hannon helps clients connect with their gifts and strengths, and make heart-centered decisions. With a master’s degree in psychology from Columbia University and bachelor’s in psychology from University of Massachusetts, Amherst, Julie worked for over 20 years as a human resources director. She then trained in the healing...