What Is MAFLD? When Alcohol Is Not The Only Reason For Fatty Liver

MAFLD is the most common liver disorder. It can progress to serious liver conditions and heart disease. While often asymptomatic, MAFLD is largely reversible, especially in the early stages.

MAFLD occurs when excess fat builds up in the liver.

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By Dr Manoj AG

Fatty liver disease is no longer a condition limited to those who consume alcohol. In fact, the most common cause today is metabolic dysfunction, not alcohol intake. That’s why the term MAFLD (Metabolic Dysfunction-Associated Fatty Liver Disease) has replaced the older term NAFLD (Non-Alcoholic Fatty Liver Disease) — to better reflect the real, underlying cause.

What Is MAFLD?

MAFLD occurs when excess fat builds up in the liver due to metabolic health problems like obesity, insulin resistance, high blood pressure, or high cholesterol. It is now considered the most common liver disorder worldwide, affecting millions, including young adults and even children.

MAFLD is diagnosed when imaging or tests show fat in the liver along with one or more of the following:

• Overweight or obesity
• Type 2 diabetes
• Metabolic abnormalities (like high triglycerides or low HDL cholesterol)

Unlike NAFLD, which was a diagnosis of exclusion, MAFLD focuses on inclusion — if you have liver fat and metabolic dysfunction, you meet the criteria.

Why Understanding MAFLD Is Important

MAFLD is often silent in the early stages, making it easy to miss. However, it can progress over time to more serious liver conditions, including:

• Steatohepatitis (inflammation of the liver)
• Fibrosis (scarring of liver tissue)
• Cirrhosis (advanced scarring and poor liver function)
• Liver cancer

Even more importantly, MAFLD is closely linked to heart disease, which remains the leading cause of death in these patients.

Common Symptoms Of MAFLD

Most people with MAFLD have no symptoms, especially early on. When symptoms do occur, they may include:

• Persistent fatigue
• Discomfort or dull pain in the upper right abdomen
• Loss of appetite or early fullness
• Unexplained weight changes

As the disease progresses, more serious signs may appear, such as:

• Yellowing of the skin or eyes (jaundice)
• Swelling of the abdomen or legs
• Mental confusion or difficulty concentrating
• Dark urine or pale stools

These symptoms often signal advanced liver disease and require immediate medical attention.

How Is MAFLD Managed?

Currently, there is no specific medication approved to treat MAFLD, but the good news is that it is largely reversible, especially in the early stages. Management focuses on:

• Weight loss: Even a 7–10% reduction in body weight can improve liver health.
• Healthy eating: A Mediterranean-style diet rich in fruits, vegetables, lean proteins, and healthy fats is ideal.
• Regular exercise: At least 150 minutes of moderate activity per week.
• Managing blood sugar, cholesterol, and blood pressure
• Avoiding alcohol and unnecessary medications that may stress the liver

MAFLD is a lifestyle-related liver condition that is quietly on the rise. Because it often develops without symptoms, many people don’t know they have it until complications occur. The key to prevention and treatment lies in addressing the root cause: metabolic health. By adopting healthier habits and getting regular checkups, it’s possible to protect your liver — and your overall well-being.

Dr. Manoj AG is a Consultant Physician on Practo.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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