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Fatty Liver Grade 2 Treatment

Grade 2 on an ultrasound report is a common finding, and on its own it is not a reason to panic. It tells you how much fat is in the liver, not how much scarring there is.

Medically reviewed by the RIIMS medical team · Last updated: June 2026

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  • Yellow eyes or skin (jaundice)
  • Swelling in the abdomen or legs
  • Vomiting blood, or black tarry stools
  • Confusion or unusual drowsiness

What does Grade 2 fatty liver mean?

An ultrasound report grades fatty liver from Grade 1 to Grade 3 based on how bright, or echogenic, the liver tissue looks on the scan. Grade 2 means a moderate increase in that brightness, along with reduced visibility of the walls of the portal vein and the diaphragm, findings a radiologist reads directly off the images. This grading is a measure of fat content alone. It says nothing about scarring, or fibrosis, which is the change that actually predicts how the liver will do over the years. A patient with Grade 2 fat and no fibrosis is in a different position to a patient with Grade 1 fat and significant fibrosis, even though the second report reads as the milder one on paper. If your report says Grade 2, the useful next question is not how to get back to Grade 1, but what your fibrosis risk actually is, usually answered with a FIB-4 score calculated from routine blood tests, or a FibroScan if FIB-4 is borderline or your doctor wants a closer look.

Symptoms to watch for

  • Usually no symptoms at all
  • Mild fatigue
  • A dull ache under the right ribs, occasionally
  • Found on a routine or incidental ultrasound
  • Raised SGPT or SGOT on a blood report
  • A normal weight does not rule it out

How RIIMS approaches it

  • A FIB-4 score from routine blood tests (age, AST, ALT and platelet count) to screen for fibrosis risk, since the grade itself only measures fat
  • FibroScan or a similar elastography test if FIB-4 is borderline or your doctor wants a closer look at scarring
  • Waist circumference and metabolic screening (sugar, lipids, blood pressure), not BMI alone
  • A realistic, gradual weight-loss target guided by your reports, generally 7 to 10%
  • Repeat imaging at an appropriate interval to track change, not a one-off scan

When to consult a doctor

See a doctor if your ultrasound report shows Grade 2 fatty liver, even if you feel completely well. Ask specifically about your fibrosis risk, since the grade printed on the report does not answer that question by itself.

Medical disclaimer: Information on this site is for awareness only and does not replace medical consultation. Treatment depends on doctor evaluation and patient reports. RIIMS does not promise guaranteed cure or recovery.

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