Fatty liverĀ occurs when too muchĀ fatĀ builds up inĀ liverĀ cells. Although it is normal to have a tiny amount ofĀ fatĀ in these cells, theĀ liverĀ is consideredĀ fattyĀ if more than 5% of it isĀ fatĀ ( 2 ). While drinking too much alcohol can lead toĀ fatty liver, in many cases it does not play a role.