Researchers have identified an interesting link between fatty liver disease and personality disorders. They say people with non-alcoholic fatty liver disease (NAFLD) face a three times higher risk of personality disorders.

The research team from the University of Birmingham also made a fascinating finding that people with NAFLD, who need to maintain a careful diet and exercise regime to manage the condition, frequently exhibit uncontrolled eating behaviors. The findings were published in BMC Gastroenterology.

"Finding an increased prevalence of personality disorders in NAFLD patients is particularly striking, signifying that it's not an issue associated with all liver disease, but just those with NAFLD," Dr. Jonathan Catling, a co-author of the study, said in a news release.

NAFLD is the most common form of chronic liver disease, caused due to excessive accumulation of fat in liver cells. It is associated with factors such as obesity, insulin resistance and high blood sugar.

Patients often do not show any obvious symptoms, but some people may experience fatigue and discomfort in the abdomen. When the disease progresses, it can cause liver damage and cirrhosis, especially in people with an increased risk of diabetes, heart attacks and strokes.

The treatment strategy mainly involves lifestyle interventions, including exercise and diet. However, patients often fail to make the behavioral changes necessary for the treatment. The latest study examined the factors that influence patients' responses toward the treatment regimes.

Researchers gathered data from 96 participants who were split into three groups – NAFLD patients, non-NAFLD liver disease patients, and healthy people. The eating and exercising behaviors were assessed from questionnaires.

The team also examined participant's locus of control – the extent of control they believe they have on their own lives. Patients with a high internal locus of control are more likely to lose weight and those with a high external locus of control are less likely to stick to diet and exercise regime.

According to the researchers, patients with NAFLD, much like individuals dealing with substance abuse disorders, have heightened external locus of control (LoC). This means they have difficulty making and maintaining changes to their diet and exercise routine essential for controlling disease progression.

"Three factors were found to be significant by group; cognitive restraint, uncontrolled eating and SAPAS score (a measure of personality disorders). An association between personality disorders and NAFLD was identified," the researchers wrote.

"Importantly, it appears not to be a general mental health issue, as neither anxiety nor depression was found to be significantly different between the groups – despite both psychiatric disorders often being associated with chronic liver disease," Dr. Catling said.

Researchers call for screenings for personality disorders among NAFLD patients so that mental health disorders can be treated well before they influence the patient's diet and exercise.

"Our findings suggest an urgent need to examine attitudes towards diet and exercise so that we can better understand how to motivate NAFLD patients and deliver more effective treatment - preventing disease recurrence after liver transplantation," Dr. Catling added.