Metabolic dysfunction-Associated Steatotic Liver Disease
It’s a condition where excess fat builds up in the liver due to metabolic issues like obesity and diabetes etc.
Raising awareness about fatty liver disease, also known as MASLD.
Fight against the silent fat!
use your
or
Where is the liver located?
It’s nestled in the top right portion of your abdomen, just under the ribcage, tucked up with the stomach.[2]
Blood flows straight from your stomach and intestines into the liver,[2] which serves as a gatekeeper of the nutrients and chemicals the body absorbs from its guts.
Why is the liver important?
You probably don’t give your liver much thought, and that’s completely normal. In fact, many people don’t know where it is exactly, or what it does.
Manufactures several important substances
including bile, helping to break down and absorb fats from the things you eat, and blood proteins, important in controlling bleeds, preventing blood clots, and stopping your blood from leaking into surrounding tissues.[2]
Removes harmful chemicals and waste
Such as cholesterol, hormones and drugs.[2]
Stores and releases energy
from sugars, and processes proteins, fats, carbohydrates, vitamins, and minerals.[2]
What is MASLD?
Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) is a form of liver disease.[4] It’s a condition where excess fat builds up in the liver due to metabolic issues like obesity and diabetes, which can lead to permanent liver damage and severe health problems if not addressed.[4] Its prevalence is growing rapidly worldwide.[3]
MA
Metabolic dysfunction-Associated
Metabolic dysfunction means there is an underlying disruption in the way your body processes energy from the food/drink you consume.[5]
S
Steatotic
A steatotic disease is one involving the build-up of fatty deposits in a particular place in the body, in this case, the liver.[4]
LD
Liver Disease
Having a properly working liver is vital to life – in MASLD the liver doesn’t work as well as it should.[2,3] MASLD is a serious and chronic (long-term) health condition that needs careful management.[3,4]
Roughly one in three people has MASLD
(though they might not know it)[6]
Those with other health conditions are even more likely to get it.[3,4,5,6]
What can happen if MASLD is untreated?
The liver is so important to overall health that if it is struggling, the rest of the body struggles too.[2,3,4,5]
1 Healthy liver
A healthy liver works quietly and without specific warning signs. Liver problems often appear only through non-specific symptoms, or they may develop for a long time without any symptoms at all.[22]
2 Fatty liver (Steatosis)
Fat begins to accumulate in the liver, usually as a result of metabolic problems such as obesity or diabetes. This stage often has no symptoms, but it increases the risk of further progression.[22]
3 MASH
At this stage, fat in the liver triggers an inflammatory reaction and liver cells begin to be damaged. The disease may still progress without clear symptoms, but the risk of further scarring of the liver tissue and worsening of the condition increases significantly.[22]
4 Tissue scarring (Fibrosis)
Repeated inflammation leads to the formation of scar tissue. The liver is still able to function, but its performance decreases. This stage is still reversible if the cause of the damage is removed.[22]
5 Liver cirrhosis
This is severe and extensive scarring of the liver tissue. The liver loses its ability to regenerate and its functions are seriously impaired. At this stage, serious complications may occur, such as bleeding, swelling, or liver failure.[22]
5 Liver failure / cancer
If MASLD and other related conditions aren’t managed properly, both liver and overall health continues to get worse over time, eventually leading to complete liver failure and/or cancer.[6,13,14,22]
Successful transplant and/or cancer treatment is likely the only chance of survival.[6,14,22]
Impact on the rest of the body
Untreated MASLD impacts other organs and body systems, leading to serious health consequences.[4,15]
- Cancer e.g. bowel/colon[7]
- Circulatory system problems[8]
- Kidney problems[7]
- Coronary artery disease and heart problems[8]
- Diabetes or inability to process sugar properly[8]
A silent killer
MASLD does not hurt[8] – but it increases the risk of a severe or fatal event like a heart attack.[4,5,6]
Just having MASLD can make you more than 8× more likely to die from a heart attack or stroke.[12]
Who is at greater risk of getting MASLD?
Depending on things like age, genes, lifestyle choices (e.g. eating, alcohol, activity levels, smoking) and/or other conditions, some people are more likely to get MASLD than others.[3,4,5]
From the following options, select all that apply to you.
Overweight or obesity
(7–9 in 10 will have MASLD)[4,5]
Diabetes
(nearly 3/4 will have MASLD)[10]
High blood pressure
(roughly 50% chance you have MASLD)[7]
High cholesterol
(roughly 50% chance you have MASLD)[7]
None of the above.
But… early liver disease is reversible.[3,5]
If you have any of these conditions, your healthcare provider will check periodically for the development of MASLD.
MASLD is difficult to spot
Some people get symptoms with MASLD, others do not.[1,6] Even if you do get symptoms, it is sometimes hard to show they are because of MASLD.[8] MASLD can be diagnosed in a number of ways[8,11]
Blood tests
They can check for elevated levels of liver enzymes (which the liver normally produces as part of its function). If these enzymes—such as AST, ALT, ALP, or GGT—appear in higher amounts in the blood, it may be a sign that the liver is overloaded or damaged.
Scan
Usually an ultrasound which can also be referred to as elastography. This handheld scanning device pulses painless sound waves into your abdomen to build up a picture of your liver and any areas of stiffness or scarring it might have.
Biopsy
A small sample of liver tissue is taken using a thin needle and then examined under a microscope to determine the exact type and extent of the damage.
Check for MASLD
If you haven’t been tested recently for MASLD, it’s ok to ask for a check.[4,8]
Your plan to prevent or treat MASLD starts now!
There are several things you can do today to manage your liver health.[8] Doing these can reduce your chance of MASLD getting worse, reverse the early impacts and health risks associated with it, and hopefully add quality years to your life[5,8]
From the following options, select the items you are willing to do for your liver and for your overall health and strength.
Diet
Weight management
Movement
Keep to your treatment plan
Regular check-ups
Healthcare guidance
How can it be improved?
Eating to save your health
The ecosystem of bacteria in your gut (your microbiome) is like a garden you can tend to.[13,17] The ‘mediterranean plan’ suggests foods you can eat that promote your microbiome, heart, and overall health and that may enable you to reduce or eliminate unhelpful bacteria that are living in your guts and may be contributing to your MASLD.[8,13] One of the most important things to work on is getting the right proportions of different food types.
Moving your body
Whether or not you’re in the habit of walking whenever you can, attending twice-weekly social movement classes (such as dance, yoga, swimming or exercise), or tuning into home workout videos every so often – chances are you can do more.[8] And the more you move, the more your liver (and your body, and your mind) will thank you for it[8,14]
Reduce stress and slow down
Rushing life and rushing food can both lead to unhelpful outcomes. Try to work out ways to reduce your stress levels and build in longer for your both preparing and eating meals, as well as winding down and preparing for restful sleep.
Reduce alcohol intake
Although MASLD is separate to liver disease caused by drinking alcohol, it is still a liver disease – and it will help you if you can cut down or eliminate alcohol from your diet.
The Mediterranean plan
Every meal
- Fruits (1-2) vegetables ≥ 2s in a variety of colours & textures, cooked or raw
- Olive oil
- Bread/pasta/rice/couscous
- Other cereals 1–2 s, preferably whole grain
- Water and herbal infusions
Daily
- Dairy 2 s (preferably low fat)
- Olives/nuts/seeds 1 –2 s
- Herbs/spices/garlic/onions for a variety of flavours to substitute salt
Weekly
- Sweets ≤2 s
- Potatoes ≤3 s
- Red meat ≤2 s
- Processed meat ≤1 s
- White meat 2 s
- Legumes ≥2 s
- Fish/seafood ≥2 s
- Eggs 2–4 s
Try intermittent fasting
Restricting eating to a particular time may allow your microbiome chance to process your food and drink eff ectively, and may encourage particular species of helpful bacteria to thrive.
Bon voyage!
We wish you all the best with your journey of experimentation and discovery towards a healthier liver.
In summary
- If you have high BMI, obesity, high waist circumference, type 2 diabetes, high cholesterol, and/or high blood pressure, you’re even more likely to have MASLD.[4,5,6,7,8,9,10,11]
- Beware the secret killer: MASLD doesn’t hurt, but if it isn’t diagnosed and treated properly it can lead to severe health complications such as heart attacks and premature death.[4,5,6,7,8]
- If treated and managed properly, MASLD can be reversed to a healthy state.[3,5]
- It’s ok to ask for a MASLD or liver check-up every now and again.[4,8]
- Make healthy lifestyle choices – and stick to any treatments or check-ups you are offered.[8]
Please remember, the information in this guide does not replace the guidance of your healthcare team, and you should discuss with them any lifestyle changes it may prompt you to consider.
Bookmark this page to refer back to—you may want to share it with family and friends who can support any changes you choose to make.
Stick to the plan
Taking your medicines as prescribed will give you the best chance for them to work.
If you experience any side effects, please contact your healthcare team, who can report your side effects and give you advice on how to manage them effectively so that you can continue with your treatment.
What can we take away from this?
The liver works quietly
The liver can go a long time without sending clear warning signals, yet it plays a key role in energy, metabolism, and overall health. That is why it is important to pay attention to it before problems appear.
Small changes have a big impact
Improving eating habits, increasing physical activity, and adopting a healthier lifestyle overall can significantly ease the burden on the liver and, in many cases, slow down or stop the progression of damage.
Prevention starts with information
Understanding the risks and checking liver health early provides the chance to act before serious damage occurs. Information is the first step toward a healthier future.
Did you know all of this?
How would you rate your knowledge about MASLD (fatty liver disease)?
I didn’t know anything at all.
Not really.
About half and half.
Mostly yes.
Yes, I know everything.
How would your liver react to your answer?
Why was this website created?
Awareness about fatty liver disease, also known as MASLD.
Purpose, mission, vision
Our purpose is to raise awareness about liver health and translate expert knowledge into a form that is understandable for patients. We aim to support prevention and help people better understand how to take care of their health.
Our mission is to contribute to awareness in the field of liver diseases through verified information and education. We strive to ensure that patients have access to clear and trustworthy information that helps them make informed decisions about their health.
In the long term, we support the sharing of expert knowledge about the importance of prevention and early recognition of health risks. We believe that awareness and cooperation between patients and professionals contribute to a healthier future.
FAQ
Who does MASLD affect? At what age?
- MASLD can affect people of all ages, including children.[22]
- It occurs in all races and ethnicities.[22]
- The risk increases with age, and people are more likely to develop chronic liver disease as they get older.[22]
- It is more common in people with conditions such as obesity and type 2 diabetes.[22]
How can I tell if I have fatty liver? Are there any symptoms?
- MASLD is often considered a “silent disease” with few or no symptoms.[22]
- Many people do not realize they have it until it is detected during medical tests.[22]
How is MASLD diagnosed? Does it hurt?
- MASLD is typically identified through medical tests (such as blood tests or imaging) rather than symptoms.[22]
- Because diagnosis relies on these tests and not on painful symptoms, it does not inherently “hurt” to diagnose, although specific procedures depend on the test used.[22]
What lifestyle changes help the most?
- The most important changes focus on improving overall metabolic health, especially weight management, healthy diet and regular physical activity.
- These changes help reduce fat in the liver and lower the risk of disease progression.[22]
Is there any way to prevent MASLD from developing in the first place?
-
Yes — prevention is mainly about addressing risk factors:
- maintaining a healthy weight
- staying physically active
- managing conditions like type 2 diabetes and metabolic disorders
- Because MASLD is strongly linked to metabolic health, healthy lifestyle habits can significantly reduce the risk of developing it.[22]
References used to create this guide
1. Sultanova BP, et al. Interdisciplinary Approaches to Medicine 2023;4(1). 2. Newman T. Medical News Today. Available at: medicalnewstoday.com/articles/305075#regeneration (last accessed March 2025). 3. Lazarus JL, et al. Nat. Rev. Gastroenterol. Hepatol. 2022;19:60–78. 4. EASL–EASD–EASO Clinical Practice Guidelines. Diabetologia (2024). 5. Huttasch M, et al. Metabolism. 2024;157:155937. 6. Chan W-K, et al. J Obes Metab Syndr. 2023;32(3):197–213. 7. Marjot T, et al. Endocr. Rev 2020;41(1):bnz009. 8. Franque SM, et al. JHEP Rep 2021;3(5):PMC8514420. 9. Safizadeh F, et al. Int J Obes (Lond) 2024; 1–8. 10. Younossi ZM, et al. Clin Gastroenterol Hepatol. 2024 Oct;22(10):1999–2010.e8. 11. Lala V, et al. Liver Function Tests. NCBI Bookshelf. Available at: https://www.ncbi.nlm.nih.gov/books/NBK482489/?report=printable (last accessed March 2025). 12. Goh BG and McCullough AJ. Dig Dis Sci 2016;61(5):1226–33. 13. Bellentani S. Hepatoma Res 2020;6:29. 14. Haldar D, et al. J Hepatol. 2019;71:313–22. 15. Targher G, et al. Lancet Gastroenterol Hepatol. 2021;6(7):578–88. 16. Achufusi TGO, et al. Ursodeoxycholic Acid Treasure Island (FL): StatPearls Publishing; 2024 Jan. 17. Houghton D, et al. Int. J. Mol. Sci. 2016;17(4):447. 18. Shah NM, et al. J Thorac Dis 2020;12(Suppl 2):S248–60. 19. Ali H, et al. J. Pers. Med. 2024;14:61. 20. Kaczmarek JL, et al. Am J Clin Nutr 2017;106:1220–31. 21. Grave RD, et al. Psychol Res Behav Manag. 2013;6:101–10. 22. AMERICAN GASTROENTEROLOGICAL ASSOCIATION. Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH). Online. GI Patient Center. 2026. Available on: https://patient.gastro.org/masld-mash/.