Fatty Liver Advice? Help?

I'm 30 years old.  Light drinker, meaning I have a few drinks a week, and a social smoker.

I was slightly overweight at 6'0", 200lbs and have since dropped 20 lbs to 180.

I had a liver biopsy and was dx with fatty liver, however despite taking Welchol for high cholesterol (265) and dropping 20lbs, my liver enzyme tests have actually gotten worse.

I realize that metabolism has much to do with my fatty liver including insulin resistance as well as cholesterol and triglycerides, but I'm at a loss currently to how to deal with my elevated enzymes.

It is definitely a familial, genetic issue with me but how can I lower cholesterol without destroying my liver?  How can I lower my liver enzymes as well?  I'd love to get my cholesterol and liver enzymes down but so far diet and exercise isn't working.

My gastroenterologist that ordered the biopsy has only put me on Ursodiol, which has had a minimum effect, and fish oil to keep my triglycerides down, which they have dropped.

The Welchol was ineffective, and has been discontinued.

My current levels are:


Cholesterol- Total   265
Triglycerides             184
HDL Cholesterol                      49
VLDL Cholest Calc   37
LDL Cholest Calc       179

Liver Enzymes
AST 78
ALT 220
GGT 197
Glucose              05