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1Clear out junk files and repair common Windows errors2Fix the driver behind crashes, sound loss and screen glitches3Repair Windows errors before they cause bigger problemsFatty liver disease means excess fat has built up in the liver. The metabolic form is now called metabolic dysfunction-associated steatotic liver disease (MASLD); when it also involves inflammation and liver-cell injury, it is called metabolic dysfunction-associated steatohepatitis (MASH). Many people have no symptoms, so the next step after a scan or blood-test finding is usually to assess whether scarring is present—not to guess the stage from how someone feels.
What is fatty liver disease?
Fat in the liver is called steatosis. When it is associated with metabolic risk factors, clinicians use the newer term MASLD. If fat is accompanied by inflammation and liver-cell injury, the condition is MASH. These names replace the widely used terms non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), which may still appear in older records, patient information, and some drug labeling. The 2024 EASL–EASD–EASO guideline explains the updated terminology.
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MASLD is one reason fat can accumulate in the liver, but it is not the only one. Alcohol, medicines, and other liver conditions can also be relevant, so a clinician may need to consider these possibilities rather than treating every finding of liver fat as the same disease.
Fatty liver often causes no symptoms. Fatigue or discomfort in the upper-right abdomen can occur, but neither is specific enough to diagnose it, and feeling well does not rule out liver scarring.
What causes fatty liver?
MASLD is associated with metabolic health, but its causes are multifactorial and still being studied. Commonly associated factors include:
- Overweight or obesity, though a person does not need to have obesity to develop fatty liver.
- Insulin resistance or type 2 diabetes.
- High triglycerides, abnormal cholesterol, or metabolic syndrome.
- Physical inactivity and dietary patterns.
Genetics and other biological factors can also contribute. Alcohol intake, medicines, and other liver diseases may affect the evaluation. A diagnosis is not a judgment about a person’s choices or body size; clinicians consider the whole health picture.
What are the stages of fatty liver disease?
Clinicians and patient resources often describe a possible progression through four stages. These stages are not a timetable, and not everyone moves through them or develops advanced disease. The NHS overview describes the stages in patient-friendly terms.
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| Stage | What it means |
|---|---|
| Steatosis | Excess fat is present in the liver without the inflammatory injury described in MASH. |
| MASH (formerly NASH) | Fat is accompanied by inflammation and liver-cell injury; scarring can develop. |
| Fibrosis | Scar tissue has accumulated. The degree of fibrosis is important when assessing risk. |
| Cirrhosis | Extensive, advanced scarring can impair liver function and lead to complications, including liver failure and liver cancer. |
Many people do not reach advanced fibrosis. A symptom, routine blood result, or single scan cannot establish an individual’s stage or predict what will happen next.
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How do clinicians assess fatty liver?
A finding may first appear incidentally on imaging or blood tests. Assessment typically combines medical history and examination with metabolic risk, alcohol intake, medicines, and other possible causes of liver fat. Blood tests and imaging can help, but a liver-enzyme result alone does not establish the full diagnosis or stage.
The practical question is often whether significant fibrosis is present and whether further assessment is warranted. NIDDK’s diagnosis guidance describes non-invasive fibrosis scores such as FIB-4 and follow-up imaging such as transient elastography when indicated. A liver biopsy can clarify disease features in selected cases; it is not inevitable for everyone.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What happens next after a fatty liver finding?
Understand what the finding does—and does not—show
Ask the clinician who identified it what test showed liver fat, whether other causes need consideration, and whether the available information is enough to estimate fibrosis risk. Further tests depend on the person’s history and initial results; a scan showing fat does not by itself determine whether MASH or advanced scarring is present.
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For people for whom weight loss is appropriate, gradual weight loss, healthier food choices, portion awareness, and physical activity are common parts of care. NIDDK says losing at least 3% to 5% of body weight can reduce liver fat; some people may need to lose 7% to 10% to reduce liver inflammation and fibrosis. These are population-level figures, not an individualized target. Physical activity may help even without weight loss, while rapid weight loss and malnutrition can worsen liver disease. NIDDK’s treatment guidance provides this context.
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Ask whether a prescription option applies
As of October 4, 2026, current U.S. FDA labeling includes resmetirom (Rezdiffra) and semaglutide (Wegovy) for adults with noncirrhotic MASH and moderate-to-advanced fibrosis (F2–F3), alongside diet and exercise. These are options for a defined group, not general treatments for everyone with liver fat. A clinician must assess diagnosis, fibrosis stage, potential benefits and risks, and whether either medicine is appropriate; availability and authorization may differ outside the United States. See the FDA’s 2026 resmetirom prescribing information and its 2025 semaglutide approval announcement.
The FDA’s 2025 announcement estimated that 14.9 million people—about 6% of U.S. adults—have MASH. This is an FDA-reported estimate for MASH, not for all liver fat or global prevalence. FDA announcement.
Be cautious with detoxes and supplements
“Liver detox” products are not a substitute for clinical assessment or treatment. NIDDK advises discussing supplements with a clinician because some herbal remedies can damage the liver. NIDDK treatment guidance.
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