Is it fatty liver disease?

You don’t have to drink large amounts of alcohol to develop fatty liver disease.

While heavy alcohol use can damage liver cells, promote inflammation, and weaken the body’s natural defenses, fatty liver disease can also develop in people who drink little or no alcohol. This condition, known as Metabolic dysfunction-associated steatotic liver disease (MASLD), is commonly associated with obesity, type 2 diabetes, high blood pressure, and high cholesterol.

According to the American Liver Foundation, approximately 100 million people in the US have MASLD. It occurs when more than 5 percent of the liver’s weight is fat.

About 13 percent of people with MASLD also develop Metabolic dysfunction-associated steatohepatitis (MASH). MASH is a more severe and aggressive form of MASLD and can cause swelling, inflammation, and liver damage.

MASLD and MASH can lead to more serious complications, such as fibrosis (scarring in the liver). Fibrosis can progress to cirrhosis (severe liver scarring).

People who are overweight or obese are more likely to develop MASLD and MASH. The risk is even higher in people with type 2 diabetes. Other risk factors include a diet high in sugar and saturated fat, smoking, high blood pressure, high cholesterol, and a sedentary lifestyle.

MASLD may cause symptoms such as fatigue, general weakness, and pain in the upper right side of the abdomen. MASLD that progresses to MASH may cause symptoms such as:

• Itchy skin
• Swelling in the abdomen, legs, or feet
• Shortness of breath
• Easy bruising and bleeding
• Enlarged spleen
• Spider-like blood vessels beneath the skin
• Jaundice (yellowing of the skin or eyes)

MASLD and MASH do not always cause symptoms, so screening is important. Screening may include blood tests and imaging studies.

While there is no cure for MASLD or MASH, lifestyle changes can help manage the condition. These include losing weight, eating more fruits, vegetables, and healthy fats, avoiding sugary foods and alcohol, and following a structured exercise program.