A health condition many Americans have never heard of is now one of the most common liver diseases in the country. Metabolically-dysfunction-associated steatotic liver disease, or MASLD, affects millions, yet most people do not realize they have it because it develops quietly.
Dr. Leana Wen, CNN wellness expert and emergency physician, explains that the disease develops when excess fat builds up in the liver in people with underlying metabolic issues. “MASLD happens when too much fat builds up in the liver of people who often have underlying metabolic problems, such as obesity and type 2 diabetes. It is not caused by heavy alcohol use.” The condition was previously known as nonalcoholic fatty liver disease, or NAFLD.
Why MASLD is becoming so common
Experts now consider MASLD the most common chronic liver disease worldwide. It affects an estimated 30% to 40% of adults globally and about one in three adults in the United States. Prevalence is even higher among individuals with obesity or type 2 diabetes, reaching 70% to 80% in these groups.
Researchers note that MASLD not only harms the liver. The condition is strongly linked with other metabolic complications, including heart disease, stroke, and certain cancers. For some, it can progress over years to inflammation, scarring, cirrhosis, liver failure, or liver cancer.
Why symptoms often go unnoticed
Most people with MASLD have no symptoms during the early stages. When signs do appear, they are typically vague, such as fatigue or mild abdominal discomfort, and can easily be overlooked, as per CNN.
As liver damage advances, more serious symptoms may develop. These include yellowing of the skin or eyes, dark urine, swelling, confusion, or severe fatigue. By this stage, significant liver injury may already have occurred.
How doctors diagnose MASLD
Doctors often first suspect MASLD when routine blood tests show mildly abnormal liver enzyme levels or when an ultrasound reveals a fatty liver. Diagnosis also includes assessing metabolic risk factors such as weight, blood pressure, blood sugar, and cholesterol.
Recent research stresses the importance of earlier screening, especially for people with diabetes or obesity, since most patients do not experience early symptoms.
Who faces the highest risk?
Individuals with metabolic conditions are at greatest risk. MASLD affects both adults and children, with about 10% of Americans aged 2 to 19 already living with the condition.
In the United States, rates are highest among Hispanic individuals, followed by non-Hispanic Whites and Asian Americans.
Can MASLD be reversed?
There is encouraging news: the condition can often be improved if addressed early. “Weight loss is the cornerstone of treatment and can significantly reduce liver fat and inflammation,” Dr. Wen says. Regular physical activity also plays a major role.
Two medications, Rezdiffra and Wegovy, have recently been approved for the more advanced stage known as MASH, but lifestyle changes remain essential.
How to protect your liver now
Health experts recommend maintaining a healthy weight, being physically active, and choosing a diet rich in lean proteins, whole grains, and vegetables while limiting added sugars and processed foods.
Managing existing conditions such as diabetes, high blood pressure, and high cholesterol is equally important.
Dr. Wen advises patients to ask their doctors whether their liver health has been evaluated, noting that simple blood tests can detect early concerns. Avoiding excessive alcohol intake and staying updated on hepatitis vaccinations also helps to protect liver health.