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You may not think about it much, but your liver is working hard for you. Every day, this vital organ helps digest food, break down medicines and remove toxins and other waste products from your body.  

But if you carry around excess body weight ¡ª especially in your midsection ¡ª you might be overwhelming your liver with fat. This can lead to a health disorder called metabolic dysfunction-associated steatotic liver disease (MASLD), an even more serious condition called metabolic dysfunction-associated steatohepatitis (MASH), and in some cases, liver cancer. 

To learn more, we spoke with internal medicine specialist Here¡¯s what she shared about how to prevent fatty liver disease, if it can be reversed, and how it¡¯s connected to liver cancer.  

Is MASLD the same thing as fatty liver disease?

Yes. MASLD was previously known as non-alcoholic fatty liver disease (NAFLD). It describes the buildup of fat in the liver of someone who drinks little to no alcohol. About 25% of people with MASLD will go on to develop MASH, which was previously known as non-alcoholic steatohepatitis (NASH). 

What¡¯s the difference between these two conditions?

MASLD can cause the liver to become enlarged due to fat buildup. But most people with it probably won¡¯t notice any symptoms.  

MASH is considered much more serious. It reflects underlying cell damage to the liver tissue ¡ª such as fibrosis (stiffening) or cirrhosis (hardening) ¡ª caused by chronic inflammation. That damage can lead to liver cancer.  

Can fatty liver disease ever be reversed?  

Before fibrosis sets in, definitely. Early fatty liver disease is reversible through lifestyle modifications such as diet and exercise. But the latter stages of cirrhosis are not reversible. Once you get to cirrhosis, it¡¯s nearly impossible to go back. 

Is fatty liver disease life-threatening?  

No, fatty liver disease is not life-threatening in the earliest stages. However, it could become life-threatening, if it progresses to cirrhosis.  

Why doesn¡¯t everyone who develops fatty liver disease eventually get MASH?

Researchers don¡¯t know why some people with MASLD develop simple fatty liver disease and not MASH. But people with MASLD are more likely to develop MASH if they have one or more of the following: 

• Obesity: This is especially true if you carry excess weight around your abdomen. 
• Type 2 diabetes (diabetes mellitus) 
• High cholesterol or elevated fat content in the blood 
• Metabolic syndrome  

Metabolic syndrome occurs when you have three or more of the following:  

• Obesity, especially around the waist 
• High blood sugar levels 
• High blood pressure 
• High triglyceride levels 
• Abnormal cholesterol levels 

What are the symptoms of MASLD?

Up to 25% of Americans have MASLD. But the disease has few symptoms and it¡¯s tough to diagnose. Some people with MASLD have elevated liver enzymes. Others don¡¯t.  

Additional tests can be done to determine if you have MASLD. Scans such as ultrasound or MRI may also show fatty liver deposits, and special imaging techniques can show if you have fibrosis or cirrhosis. 

If you aren¡¯t sure of your status, but you have metabolic syndrome or one of the conditions associated with it, it¡¯s a good idea to talk to your doctor about MASLD and MASH. 

How can I reduce my risk of developing MASLD?

In most cases, MASLD is preventable. And, the same healthy lifestyle choices that reduce your overall cancer risk will also reduce your risk for this disease. 

You can take the following steps: 

• Maintain a healthy body weight. Get to and stay at a healthy weight. This is the most important thing you can do to reduce your risk. 
• Eat a healthy diet. Fill two-thirds of your plate with vegetables, fruits, whole grains, nuts and seeds. Fill the remaining third with lean protein. Limit the amount of high-fat and high-sugar foods you eat. 
• Stay physically active. Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week. 
• Get enough rest: Your body needs adequate sleep to function well.  
• Stay properly hydrated: Your body depends on water to function properly, so make sure you¡¯re getting enough of it each day. 

You can further reduce your risk of liver disease by avoiding tobacco and limiting your alcohol. For cancer prevention, it¡¯s best not to drink alcohol. Call 1-800-784-8669 or text QUIT to 47848 to quit smoking. Cancer patients may also enroll in?MD Anderson¡¯s Tobacco Research and Treatment Program. 

or call 1-877-632-6789.