The treatment of severe fatty liver is not significantly different from that of mild to moderate fatty liver in terms of medication. The main aspects of treating severe fatty liver include: Firstly, general treatment, which encompasses a healthy diet, appropriate exercise, weight control, and avoiding liver damage. Secondly, medication treatment: Due to large individual differences, there is no absolute, best, quickest, or most effective medication. Apart from using common over-the-counter drugs, it is important to select the appropriate medication based on individual circumstances. Additionally, surgical treatment options are available. For patients with severe obesity and type 2 diabetes, or for those with moderate cases but ineffective control of blood sugar through conservative treatment, weight loss surgery can be considered. Furthermore, combining treatment with traditional Chinese medicine and herbs can also yield excellent results for severe fatty liver.