In many people, fatty liver by itself doesn’t cause too many problems at first. It can worsen slowly over time. The extra fat in the liver causes liver inflammation, which eventually leads to scarring (fibrosis) of the liver. It may also lead to more serious chronic liver disease, such as cirrhosis or liver cancer. Some people who develop severe cirrhosis of the liver need to have a liver transplant. People with fatty liver have an increased risk of heart attack and stroke.