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Fatty liver in plain words. Learn what it is, check your risk, and know what to expect at each step.
Fatty liver in plain words
What is MASLD?
MASLD means too much fat is stored in the liver, linked to weight, blood sugar, blood pressure or blood fats. Its old name was NAFLD. It affects about 1 in 3 adults worldwide, and most people do not know they have it.
What is MASH?
In some people the fat causes inflammation and damage. This is MASH. Over years it can cause scarring (fibrosis), and in a few people, cirrhosis or liver cancer.
Do I feel it?
Usually not. Some people feel tired or have mild discomfort on the right side of the belly. That is why checking people at risk matters.
Can it get better?
Yes, especially when found early. Losing about 5% of body weight lowers liver fat. Losing 10% or more can calm inflammation and may reduce scarring. In some countries, medicines are now approved for MASH with moderate or advanced scarring. Your doctor will tell you if they fit you.
Am I at risk?
Answer five quick questions. You will not get a score, only a suggestion about whether to ask your doctor for a liver check.
FIB-4 calculator for patients
A simple tool to read the FIB-4 score from your own blood test, in plain words. It is being reviewed before it goes live. Doctors can already use the clinician version in the Academy.
My liver journey
What usually happens, step by step. Your own path may be shorter or different.
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Spotting the risk
At a check-up, or in a diabetes or weight clinic, your doctor notices risk factors, a fatty liver on ultrasound, or raised liver enzymes.
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A simple blood-test score
Your doctor works out FIB-4 from your age and three routine blood results. It shows whether serious scarring is unlikely or needs a closer look.
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A liver scan, if needed
If FIB-4 is not low, a quick, painless scan (such as FibroScan) measures liver stiffness. A liver biopsy is now rarely needed.
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Seeing a liver specialist
If the scan shows more scarring, a liver specialist reviews your results and checks for other causes of liver disease.
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Your treatment plan
Food, activity and weight goals come first. Your team also treats diabetes, blood pressure and cholesterol, because they protect your heart too. Some people may also need medicines for the liver.
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Follow-up
The tests are repeated over time to see how your liver responds. People with cirrhosis also need a liver ultrasound about every 6 months to look for early cancer.
Questions to ask your doctor
- Do I have fatty liver, and how do we know?
- What is my FIB-4 score? Do I need a FibroScan?
- Is there scarring in my liver? What stage?
- How much weight should I aim to lose, and how fast?
- Are my sugar, blood pressure and cholesterol well controlled?
- Is a liver medicine right for me?
- When should I repeat my tests?
When to seek urgent care
Go to the emergency department or call your local emergency number if you have:
- Vomiting blood, or black, tarry stools
- New yellowing of the eyes or skin
- Confusion, unusual sleepiness, or behaviour changes
- A belly that swells fast, especially with fever or pain
- Fainting or severe weakness
Guides and support
Free printable guides
One-page guides in Arabic and English to print and share.
Patient support groups (in English)
- Global Liver Institute
- American Liver Foundation
- British Liver Trust online groups
- Fatty Liver Alliance patient portal
These sites are run by others. We are not responsible for their content.