A Common Liver Disease Is Silently Affecting Millions. Doctors Explain What to Know

A health condition unfamiliar to many Americans has quickly become one of the most common liver diseases in the United States. Metabolic dysfunction–associated steatotic liver disease, known as MASLD, affects roughly one-third of adults nationwide, often without showing symptoms until the disease has significantly progressed.

MASLD develops when excess fat accumulates in the liver, most often in people with underlying metabolic issues such as obesity or type 2 diabetes. Previously known as nonalcoholic fatty liver disease, MASLD has increased in prevalence alongside rising rates of diabetes and obesity. According to studies cited in JAMA, the disease impacts up to 80 percent of people with obesity and up to 70 percent of those with type 2 diabetes.

Many patients with MASLD do not develop severe complications, but the condition can lead to inflammation, scarring, cirrhosis, liver cancer and even liver failure over time. It has become a leading cause of liver transplantation in certain populations. Since MASLD is tied closely to broader metabolic issues, it also signals increased risk for heart disease, stroke and some cancers.

Early symptoms are often minimal or nonexistent, which makes diagnosis difficult. Some people may feel general fatigue or notice a vague fullness in the upper right abdomen, but these indicators are easy to overlook. More serious symptoms — including jaundice, dark urine, swelling in the legs or abdomen, easy bruising or confusion — typically appear only when liver damage is advanced.

Doctors often first suspect MASLD after routine bloodwork reveals mildly elevated liver enzymes or when an ultrasound shows signs of excess liver fat. Diagnosis involves ruling out other causes, such as viral hepatitis or alcohol-related liver disease, and assessing metabolic risk factors such as high blood pressure, high cholesterol, excess weight or prediabetes.

While older adults are at higher risk, MASLD can affect anyone, including children. Nearly 10 percent of U.S. children ages 2 to 19 have the condition. It is most common among Hispanic individuals, followed by non-Hispanic White and Asian American communities, and less common among non-Hispanic Black individuals.

The encouraging news, experts say, is that MASLD can often be slowed or reversed when detected early. Weight loss remains the most effective treatment, reducing both liver fat and inflammation. Regular physical activity and improved diet are essential tools for reversing metabolic strain. Two medications, Rezdiffra (resmetirom) and Wegovy (semaglutide), have recently been approved for MASH, the more advanced form of MASLD that includes inflammation and scarring, though lifestyle changes are still considered the foundation of treatment.

Doctors recommend that people with diabetes, high blood pressure, obesity or high cholesterol speak with their clinicians about liver screening. Avoiding excessive alcohol use, staying current on hepatitis vaccinations and focusing on metabolic health can all help protect the liver.

As MASLD continues to rise, experts stress the importance of awareness and early detection to prevent long-term complications.

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