Liver DiseaseConnections: What I Wish I Knew About MASH

Understanding a MASH Diagnosis: What It Means and What to Expect

It’s normal to have a lot of questions when you’re diagnosed with this advanced form of liver disease. Here’s what to know about the road ahead.

A MASH Diagnosis Doesn’t Mean My Story Is Over

Jeff’s MASH diagnosis came with questions, concerns, and uncertainty. Susan offers advice on preparing for the road ahead and safeguarding liver health.
A MASH Diagnosis Doesn’t Mean My Story Is Over

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Published on March 27, 2025
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Most people don’t have specific symptoms when they’re diagnosed with metabolic dysfunction–associated steatohepatitis (MASH), so being told you have this advanced liver disease can come as a surprise.

Not only is MASH a relatively unknown condition, but until 2023, it wasn’t even called MASH. It was known as nonalcoholic steatohepatitis, or NASH, a serious form of nonalcoholic fatty liver disease. (The name was changed to remove the stigma associated with the terms “alcoholic” and “fatty.”)

MASH occurs when fat builds up in the liver, which can cause inflammation and, eventually, liver damage. “People with a lot of inflammation are at higher risk for getting scarring, called fibrosis,” says Kara Wegermann, MD, a gastroenterologist and transplant hepatologist at Duke Health in Durham, North Carolina, and a volunteer for the American Liver Foundation. “And the scarring … is the driver of liver-related outcomes, [such as complications from cirrhosis or liver cancer].”

If you’ve been diagnosed with MASH, here’s what you should know about it and what you can do to help safeguard your health.

What I Wish I Knew: MASH Progresses Differently for Everybody

Jeff headshot
I had never heard of [MASH]. I didn’t realize that fatty liver could turn into MASH, and I didn’t realize that it was a terminal illness.
— Jeff Beckley, diagnosed with MASH in 2024

MASH is the last and most severe stage of metabolic dysfunction–associated steatotic liver disease, an “umbrella term for fat in the liver in people with metabolic risk factors [such as obesity and type 2 diabetes],” says Dr. Wegermann.

When MASH progresses from fibrosis to cirrhosis — a severe form of liver scarring that damages the liver — it can shorten a person’s life expectancy. In the early stages of cirrhosis, with no complications of liver disease (known as compensated cirrhosis), life expectancy can be many years. But if MASH progresses and there are other complications (called decompensated cirrhosis), the average life expectancy is seven years.

Approximately 5 to 12 percent of people with MASH end up with cirrhosis.

“Scarring or fibrosis progresses about a stage every seven years. And there are five stages, going from zero to four,” Wegermann explains. “So it takes at least a decade — if not multiple decades — to get to cirrhosis.”

What I Wish I Knew: MASH Can Lead to Cirrhosis — but Not Always

Susan headshot
When [my doctor] told me it was stage 4 [liver disease], I was devastated. I had no idea that it could progress to that.
— Susan Avallone, diagnosed with MASH in 2003

To reduce your risk of cirrhosis, it’s important to schedule regular checkups with your doctor. “If [routine monitoring] is suggestive of no scarring or fibrosis, then you should continue to work with your doctor on managing things like your weight, cholesterol levels, and blood pressure with a healthy diet and regular exercise,” says Wegermann.


But if you do start to show signs of scarring or fibrosis, you may want to meet with a hepatologist, a doctor who specializes in liver disease, she adds. “It’s important for people with stage 2 fibrosis and up to see a hepatologist.”

People who have more advanced liver disease may be able to receive further MASH treatments, including medication, she says.

What Your Doctor Wants You to Know: MASH Can Be Managed

MASH is a chronic condition, which means it can be managed. “Think about it like diabetes or high blood pressure,” says Wegermann. “It’s something that’s going to be with you every day, and you may not feel it, but it could potentially get worse without appropriate monitoring and treatment.”

Don’t be afraid to speak up and ask your doctor any questions you have, she adds. And if you prefer to work with a specialist, such as a hepatologist, to manage your disease, ask for a referral, says Wegermann. Remember: When it comes to your health, you’re in the driver’s seat, and you are your own best advocate.

Common Questions & Answers

What is MASH?
MASH is an advanced form of inflammatory liver disease. Left unmanaged, it can lead to cirrhosis (severe liver scarring) and, eventually, liver failure.
MASH often doesn’t cause any symptoms. But people with the disease can experience fatigue, pain in the upper right abdomen, or appetite loss.

Until very recently, MASH was usually diagnosed with a liver biopsy. But there are newer, noninvasive tests, such as a FibroScan or blood-based biomarkers, that can also be used to diagnose the condition.

Your doctor may initially suspect you have MASH after routine blood work detects changes in your liver enzymes. Imaging tests may then be used to look for signs of liver damage. 

Treating underlying conditions, such as obesity, high blood pressure, high cholesterol, and type 2 diabetes, with diet, exercise, and weight loss helps treat MASH. If more severe liver damage has occurred, medication may also be prescribed.
If it’s caught early enough, lifestyle changes such as losing weight, eating a healthy diet, and exercising regularly can help manage MASH — and in some cases, reverse liver damage.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Metabolic Dysfunction-Associated Steatohepatitis (MASH). Community Liver Alliance.
  2. Rinella ME et al. A Multisociety Delphi Consensus Statement on New Fatty Liver Disease Nomenclature. Hepatology. December 2023.
  3. Metabolic Dysfunction-Associated Steatohepatitis (MASH). Cleveland Clinic. May 3, 2022.
  4. Cirrhosis of the Liver. Cleveland Clinic. July 26, 2023.
Meet Our Experts
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Jonathan G. Stine, MD, MSc, FACP

Medical Reviewer

Jonathan Stine, MD, MSc, FACP, is an associate professor of medicine and public health science at Penn State in State College, Pennsylvania.

As an internationally recognized liver expert with a research and clinical focus on metabolic dysfunction–associated steatotic liver disease (MASLD) and exercise, he has authored more than 100 peer-reviewed papers, including multinational consensus guidelines.

Dr. Stine is the recipient of multiple research grants and awards from the American Association for the Study of Liver Diseases and the American Cancer Society, and has maintained continuous funding from the National Institutes of Health since 2018.

Stine is the MASLD consultant to the American College of Sports Medicine’s “Exercise is Medicine” initiative, and recently co-chaired the International Roundtable on MASLD and Physical Activity for ACSM. He serves as the Fatty Liver Program director as well as the Liver Center Research director for Penn State.

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Kerry Weiss

Author
Kerry Weiss is a New York–based freelance writer, editor, and content strategist specializing in health and wellness. She has contributed to a variety of online publications, including Healthline, WebMD, Sharecare, Twill Care, and What to Expect.
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