Managing Work and School With NASH

Reviewed by: HU Medical Review Board | Last reviewed: August 2024

Living with nonalcoholic fatty liver disease (NAFLD) or its more severe form, nonalcoholic steatohepatitis (NASH), can affect daily life in many ways. Trying to juggle the demands of work and school with NASH can be hard.1

How NAFLD and NASH can affect work and school

Both conditions involve fat buildup in the liver. This can lead to inflammation and liver damage. While they are often asymptomatic, if left untreated, health complications may arise that can impact day-to-day responsibilities like work and school.1

Physical symptoms

NAFLD and NASH often present with a range of physical symptoms that can interfere with work and school. Common symptoms include:1

  • Fatigue – Chronic tiredness can make it difficult to concentrate, complete tasks, and stay engaged.
  • Stomach discomfort – Pain or discomfort in the upper right abdomen can be distracting. And it can impact your ability to sit comfortably or move around with ease.

Mental and emotional health

The physical toll of NAFLD and NASH is often made worse by their impact on mental and emotional health:1-3

  • Stress and anxiety – Worrying about your health can increase stress levels. Increased stress can then make symptoms worse and negatively impact mental health.
  • Depression – The chronic nature of the disease and the lifestyle adjustments required can lead to feelings of sadness and hopelessness.
  • Hepatic encephalopathy – When the disease progresses to cirrhosis and the liver cannot filter the toxins in the blood, it can lead to a loss of brain function called hepatic encephalopathy. This can negatively affect memory, focus, and decision-making. It can lead to confusion and personality changes.

As the disease progresses, more frequent medical appointments may interfere with work responsibilities.

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How work impacts the development NAFLD and NASH

On the flip side, work can also impact health in many ways. Long working hours can worsen the development and progression of NAFLD and NASH. Here is how:4

  • Sedentary lifestyle – Extended periods of sitting contribute to weight gain and liver fat buildup. Sitting for long periods is common in many jobs and study routines.
  • Poor diet choices – Busy schedules often lead to reliance on fast food or processed snacks. These foods are high in unhealthy fats and sugars.
  • Lack of physical activity – Finding time to exercise can be challenging, but physical activity is crucial for managing weight and liver health.
  • Stress – High stress levels from overwork can lead to hormonal changes that promote fat storage in the liver.
  • Lack of sleep – When sleep suffers, the whole body suffers.

A 2021 study found a link between long working hours (more than 42 hours a week) and NAFLD. As working hours increased, so did the occurrence of NAFLD.4

Qualifying for disability

If a liver disease like NASH makes you unable to work, you might qualify for disability benefits through the Social Security Administration (SSA). To qualify for disability benefits, your condition must meet the SSA's definition of disability. This includes:5,6

  • Severity – Your liver disease must be severe enough to prevent you from performing substantial gainful activity (SGA) for at least 12 months.
  • Criteria – The SSA’s Listing of Impairments, also known as the Blue Book, includes specific criteria for chronic liver disease. Conditions like NAFLD and NASH may qualify if they lead to complications such as hepatic encephalopathy, ascites, or stomach bleeding.

Strategies for managing NAFLD and NASH while working and studying

There are many things you can do to prioritize your liver health while staying busy with work or school. You can:7

  • Know your risk level of NAFLD and NASH
  • Get regular health checkups to monitor your liver health
  • Take your medicines as prescribed by your doctor

Lifestyle changes are a key component of NAFLD and NASH management. The most important changes are the following.7

Eat a healthy diet

Focus on a diet rich in fruits, vegetables, lean proteins, and whole grains. The Mediterranean diet is one experts recommend for people with NASH. Avoid processed foods, sugary drinks, and excessive fats. Preparing meals in advance can help you avoid unhealthy food choices during busy times.7

Get regular exercise

Aim for at least 150 minutes of moderate-intensity exercise per week. Activities like walking, cycling, or swimming can be effective. Take short breaks during work or study sessions to stretch or walk around. This reduces the time you spend sitting.7

Manage stress

Exercise can also help manage stress levels. Also, avoid over-committing to work or school tasks. Set boundaries to ensure you have time to relax and recharge. A healthy work-life balance can reduce stress.7

Advocate for yourself

People with chronic health conditions must advocate for themselves in the workplace. Start by telling your employer or HR department about your medical needs. Share how certain accommodations can maximize your productivity and health.

Accommodations might include:

  • Flexible work hours
  • The option to work from home when necessary
  • More frequent breaks throughout the day