Merck Manuals: The Facts on Fatty Liver and its New Name

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May 08, 2024, 11:55 ET

RAHWAY, N.J., May 8, 2024 /PRNewswire/ -- The condition commonly known as "fatty liver" is serious and can have significant health consequences if not properly addressed. But with the right approach, doctors say it may be possible to control and even reverse some of its effects.

In a new editorial from MerckManuals.com, Danielle Tholey, MD, Sidney Kimmel Medical College at Thomas Jefferson University, shares a few things to consider for patients concerned about the condition. She also explains why doctors are moving away from the term fatty liver towards more detailed terminology.

1. New names combat stigmas

In 2023, the American Association for the Study of Liver Disease (AASLD) updated the nomenclature around steatotic liver disease and fatty liver. The changes include the renaming and recategorizing of different forms of steatotic liver disease.

Fatty liver due to any condition except consumption of large amounts of alcohol was previously called nonalcoholic fatty liver disease (NAFLD). Yet terms like "fatty" and the focus on alcohol can be stigmatizing, Tholey explains. In some cases, that stigma may prevent patients from seeking treatment.

The overall category of fatty liver is now reclassified as steatotic liver disease (SLD). Metabolic associated fatty liver (previously known as nonalcoholic fatty liver or NAFL) is now known as metabolic dysfunction-associated steatotic liver disease (MASLD).

2. Contributing causes go beyond alcohol use

Consumption of large amounts of alcohol is one common cause of steatotic liver disease. This condition is called alcohol-associated (or alcohol-related) liver disease.

On the other hand, MASLD includes at least one of the components of metabolic syndrome, such as excess body weight, high fat levels in the blood, or insulin resistance, says Tholey. She adds the obesity epidemic in America may be one reason for the increase in MASLD.

In some cases, a combination of metabolic factors and increased alcohol use can contribute to fatty liver. Tholey stresses even social drinking can have a negative effect, and it's not just hard alcohol that can lead to fatty liver.

3. It can be reversible with healthy habits

With the right approach and lifestyle changes, patients can improve and sometimes even completely resolve the effects of fatty liver conditions, Tholey says. Maintaining a healthy weight with a healthy diet heavy on leafy green vegetables and light on sugar and processed foods is a good start. Regular exercise, limiting alcohol use, and controlling blood pressure and cholesterol are also important.

4. Be honest with your doctor

Bottom line: For individuals concerned about fatty liver, the best first step is to have an open conversation with your physician. Tholey says it's important to be honest about your lifestyle and drinking habits. Based on that conversation, the doctor will recommend any necessary lifestyle changes and potentially refer you to a specialist for a screening or other next steps.

You can read more of Tholey's takeaways on fatty liver in this editorial on MerckManuals.com.

About The Merck Manuals and MSD Manuals

First published in 1899 as a small reference book for physicians and pharmacists, The Merck Manual grew in size and scope to become one of the world's most widely used comprehensive medical resources for professionals and consumers. As The Manual evolved, it continually expanded the reach and depth of its offerings to reflect the mission of providing the best medical information to a wide cross-section of users, including medical professionals and students, veterinarians and veterinary students, and consumers. In 2015, The Manuals kicked off Global Medical Knowledge 2020, a global initiative with the goal to make the best current medical information accessible by up to three billion professionals and patients around the world by 2020. The Manuals achieved that goal, and today its medical information is available in nearly 250 countries and in 14 languages. It's continuing its ambitious mission through outreach, education and creating new reliable medical resources. For access to thousands of medical topics with images, videos and a constantly expanding set of resources, visit MerckManuals.com or MSDManuals.com and connect with us on social media: For Consumers in the U.S. and its territories: X (formerly Twitter) and Facebook. For Professionals in the U.S. and its territories: X (formerly Twitter) and Facebook

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SOURCE The Merck Manuals