‘Fatty liver disease’ has a new name. Here’s why.

Scientists around the world have agreed to a new name and definition for the common condition known as fatty liver disease. Dr Elena George, an Advanced Accredited Practicing Dietitian IPAN researcher, explains.

Millions of Australians are living with ‘fatty liver disease’, or as it has also been known, ‘non-alcoholic fatty liver disease’. But those terms are now out of date.

In Australia, the preferred name for the condition was updated to Metabolic-associated fatty liver disease (MAFLD) in 2020. Three years later, an international consensus led by the US saw agreement to rename to ‘metabolic dysfunction – associated steatotic liver disease’ (shortened to MASLD). Along with the new name, the condition has an updated definition to boot.

Dr Elena George, an Advanced Accredited Practising Dietitian and Senior Research Fellow at IPAN, says the change was necessary to capture a broader group of people who are at risk.

About one in three Australians has MASLD, which is a build-up of fat in their liver that risks damage to the organ and has the potential to lead to serious complications.

MASLD risk increases with poor lifestyle habits including a low-quality diet, being physically inactive and smoking. Being overweight or obese is also a risk factor – up to 80 per cent of these people will have a fatty liver. Those who already have diabetes or cardiovascular disease are also at an increased risk, with about 60 per cent of people with diabetes also having MASLD. And vice versa, MASLD poses a significant risk for diabetes and CVD.

However, not everyone who has a fatty liver is overweight. The new definition for MASLD diagnosis includes people who have cardiovascular or metabolic risk factors, to acknowledge their increased risk for liver related and other health complications.

Dr George said while there are some differences in definitions, the broader diagnosis and definition have become more inclusive and less stigmatising.

“The name change is a good thing in that we are now capturing people’s risk factors more holistically. This will help healthcare professionals support more people with the condition to understand the risks and be proactive to manage it,” she said.

“The word ‘non-alcoholic’ did not accurately describe the disease, and the word ‘fatty’ was considered by many to have a stigma attached to it – so it was important to change this.”

Weight loss, supported by a balanced and healthy diet and exercise, remains the cornerstone of MASLD management.

But Dr George said while many people with MASLD are often told to lose weight, they are left largely to their own devices.

“Most people don’t have easy access to the support they need to lose weight. For example, healthcare professionals may be out of reach, especially for those who live in rural areas or those who are culturally and linguistically diverse,” she said.

Dr George is currently developing online lifestyle interventions including diet, exercise and sleep, which she hopes will be implemented into mainstream healthcare to support people to manage – and potentially reverse – MASLD, as well as reduce their risk of diabetes and cardiovascular disease.


Note: While MASLD is the agreed new name, some organisations and individuals may still use the term MAFLD.