Carlos Bruno was 41 years old when he felt the grasp of his very own American Dream. A native Venezuelan living in Miami, Florida, he landed a job as a cameraman at Univision, the No. 1 Hispanic television network in the country. Then, right on cue, his fatty liver took over the director’s role and silently yelled: “CUT!”
He was diagnosed with metabolic dysfunction-associated steatohepatitis (MASH), a nonalcoholic fatty liver disease that involves a buildup of fat and inflammation in your liver, and it can lead to serious complications if left untreated.
“I went to the doctor thinking that I had gastritis. My stomach felt inflamed all the time and my digestion was a nightmare. I always felt full and uncomfortable.”
Diagnosis Triggered New Mental Health Symptoms: Anxiety and Insomnia
Bruno wasted no time reading and studying about MASH and other fatty liver diseases.
“I read a lot on the subject. Everything made sense. My liver was processing food much slower, but I was still eating three meals a day. By the third meal, most of the previous meals had not been processed, so the liver started storing food as fat,” he says.
The diagnosis explained his digestive symptoms, his inflamed belly, his dry skin, and constant fatigue. It also triggered a couple of new ones: anxiety and insomnia.
“Mentally, I went through different stages; it felt like the end of a romantic relationship. First you cry, then you start accepting reality. Your body craves something that it can no longer have. That caused a lot of anxiety and severe insomnia,” he says.
In his 30s, Bruno enjoyed the gym, and he was fit and filled with energy, so he never paid attention to his diet. He ate what he thought made him feel good, the traditional Venezuelan favorites: arepas, cachapas, ham bread. All these delicious Venezuelan staples are based on corn flour, unprocessed corn, and cheeses, which are then fried in oil.
Bidding farewell to his favorite dishes created a lot of anxiety — Not only because they symbolized comfort for him, but also because he now knew that his liver could not process them. Instead, they created painful inflammation and released toxins into his blood, which could affect his brain function as well.
Lucero Rodriguez, MD, a psychiatrist in Doral, Florida, has treated multiple people with MASH and other fatty liver diseases for mental health related issues.
“The liver is the primary organ for metabolism in the body. A fatty liver can't remove toxins, which can build up in the blood and affect the brain. I see a lot of patients with fatty liver conditions that have confusion and disorientation, as well as physical and mental symptoms like fatigue, depression, and anxiety,” she says.
There are more severe side effects from untreated liver disease that can affect your mental health.
“Untreated MASH can lead to hepatic encephalopathy (HE), when toxins affect your brain so fiercely that it leads to severe depression, dementia, and even bipolar disorder, since behavior inhibitions are reduced,” says Rodriguez.
Medications Can Help, but Bruno Chose Lifestyle Changes
“I approached my condition radically,” Bruno says. “I eliminated sugar from my life, since it sticks to the liver as fat. I eliminated most carbohydrates, even the good ones, and added more protein and greens, which is something I was not used to.”
These drastic diet changes were especially tough for a Venezuelan whose primary diet growing up was based on corn and flour.
“I used to eat a fried arepa every day. It was my comfort zone — what I knew. It was fixed on my nutrition’s hard drive. Sometimes I really want one — I am my worst enemy at times — but then I remember how well I feel without it and it's 100% worth the willpower,” he says.
He also got rid of corn from his diet. Every “painful” step paid off.
“I am 5’ 7 and weighed 216 pounds when I received my diagnosis. Four years later, I weigh 187 pounds. I do cardio and stretching in the morning and walk an hour and a half each night. I now sleep better than I ever did.”
Mental Health Medications Must Be Carefully Prescribed
Rodriguez points out the importance of disclosing your liver disease diagnosis with your mental health provider.
When treating people with anxiety or depression, it's important to use medications that aren’t processed by the liver, she says. Some medications are passed through your kidneys and can be very helpful in lowering anxiety symptoms.
The National Library of Medicine says that treating mental health and chronic illnesses should take a team approach. There needs to be a change in how we currently treat these issues because the connection between fatty liver, mental health problems, and weight gain is complicated.
Bruno is now 45 and says he has never felt better despite the difficult changes that are now becoming lifestyle routines rather than sacrifices.
“The condition can’t be cured, but it can be improved. Commitment to a healthier lifestyle is lifelong, but trust me, your overall health will thank you for it,” he says.
Recap
- Don’t wait for your symptoms to get intense – get checked for fatty liver disease if you think you may have it.
- Take action upon diagnosis: Follow expert instructions and educate yourself to make better life choices.
- Modifying your diet to a liver friendly option is worth it. You’ll feel great!
- Exercise, walk, dance, swim: The more fat you lose, the less fat will be stored in your liver.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Carlos Bruno, cameraman, Televisa Univision, Miami, Florida.
Lucero M. Rodriguez MD, PA, psychiatrist, Doral, Florida.
National Library of Medicine: “Psychological and Psychiatric Aspects of Treatment of Obesity and Nonalcoholic Fatty Liver Disease.”
Karen E. Stewart, PhD, Department of Psychiatry, Virginia Commonwealth University.
James L. Levenson, MD, Department of Psychiatry, Virginia Commonwealth University.
