Recently had an abdominal ultrasound and my liver shows the echo texture is coarsened and suggests fatty changes. Is this serious?

It can be. In some patients, fatty liver can cause inflammation and create an illness called nonalcoholic Steatohepatitis (NASH). It is possible for this to result in the liver damage. At this point, I would recommend that you try to work on losing weight if you are heavy, and see your doctor for further work up to be sure your liver is okay. Good luck.