Myths and Misconceptions

Metabolic dysfunction-associated steatohepatitis (MASH) is a serious liver disease that has become more common in recent years. Understanding MASH is crucial for early detection, effective management, and improved health outcomes.¹

There are several common misconceptions about MASH and other liver conditions. But it is vital to separate fact from fiction.

Myth: Only people who drink alcohol get MASH and other liver diseases

One of the most common myths about MASH is that it affects only people who drink a lot of alcohol. This is false. MASH is a type of Metabolic dysfunction-associated steatotic liver disease (MASLD). In these conditions, fat builds up in the liver of people who drink little to no alcohol.²

Unlike alcohol-related liver disease, MASH can develop in people who do not drink alcohol at all. It is linked primarily with health problems like:²

• Obesity
• Type 2 diabetes
• High cholesterol
• High blood pressure (hypertension)
• Metabolic syndrome

Myth: MASH and MASLD are the same disease

While MASH and MASLD are related, they are 2 distinct liver diseases. Metabolic dysfunction-associated steatotic liver disease (MASLD) is an umbrella term for a range of liver conditions.²

MASH is the most severe form of MASLD. With MASH, fat buildup in the liver leads to inflammation and liver cell damage. If left untreated, MASH can result in complications like:²

• Scarring of the liver (fibrosis)
• Permanent scarring of the liver (cirrhosis)
• Liver failure
• Liver cancer

Myth: MASH is rare

MASH has become more common in recent decades. Rates are increasing due to the rise in obesity and type 2 diabetes worldwide. It is estimated that about 1 in 4 adults globally have some form of MASLD, with some of them developing MASH.^1-3

Overall, lifestyles are becoming more sedentary and diets are becoming less healthy. With these trends, rates of MASLD and MASH are expected to continue rising.^1-3

Myth: Only people with obesity get MASH

Although obesity is a major risk factor for MASH, it is not the only one. MASH can occur in people with a healthy body weight who have other health conditions that put them at risk. Genetics also plays a role. Some people are more prone to developing MASH based on their genes.⁴

Myth: MASH is easily diagnosed

Unfortunately, diagnosing MASH is not straightforward. Many people with MASH have no symptoms, especially in the early stages. When symptoms do occur, they can be nonspecific. Nonspecific symptoms may include fatigue, weight loss, and belly pain.³

Blood and imaging tests might suggest liver abnormalities. But a definitive diagnosis usually requires a liver biopsy. This can lead to delayed diagnosis and treatment.³

Myth: There is no treatment for MASH

There are many effective treatment options for MASH. Lifestyle changes, such as losing weight, eating a healthy diet, and getting regular exercise, can improve liver health and slow the progression of MASH. Controlling chronic health conditions like diabetes and high cholesterol helps improve liver health as well.⁴

In recent years, experts have made a lot of progress with medicines for the treatment of MASH. In 2024, a drug called resmetirom (Rezdiffra™) was approved to treat adults with MASH who have moderate to advanced fibrosis. This drug is meant to be combined with diet and exercise. Drugs in the GLP1 agonist class such as semaglutide (Ozempic®, Wegovy®) or tirzepatide (Mounjaro®, Zepbound®) are approved for weight loss and may also lead to improvement in MASH.⁵

Things to keep in mind

The internet can be an amazing tool for gathering information. But not everything you read online is accurate. If you are ever unsure or confused about something you have heard or read about MASH, ask your liver care team. They are a valuable resource and can answer any questions you may have.