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Your Liver 2021

NASH – the forgotten liver disease epidemic

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Vanessa Hebditch

Director of Policy and Communications, British Liver Trust 

For many people as soon as you say “liver disease” the first thing that they think about is alcohol. But there is another form of liver disease, related to obesity and type 2 diabetes. 


Non-alcohol related fatty liver disease (NAFLD) is when fat builds up in the liver. It usually occurs when people are overweight or obese. Type 2 diabetes is also a risk factor. Early stage NAFLD does not cause any harm but approximately 20% of people develop NASH (Non-Alcoholic SteatoHepatitis), a more serious form of the disease when the liver starts to scar.  

Greater awareness of fatty liver disease 

NASH is a “hidden epidemic” as there are often no symptoms in the early stages. It could affect as many as one in eight adults in the UK and is soon to be the primary reason for liver transplantation. 

Professor Stephen Ryder, a leading hepatologist and medical advisor to the British Liver Trust says “Studies suggest that the UK prevalence of NASH – the more serious form of fatty liver disease will present a huge burden on the NHS in years to come – with an increasing number of people requiring care for cirrhosis or needing liver transplants. Greater awareness of the risk factors of fatty liver disease is crucial.” 

NASH is a “hidden epidemic” as there are often no symptoms in the early stages. It could affect as many as one in eight adults in the UK.

Better access to diagnostic tools  

“We also need patients to have much better access to non-invasive diagnostic tools to help to catch people earlier in their disease, so they can make lifestyle changes or seek other treatments that will help them to prevent further damage and improve the health of their liver.”  

People are more likely to develop NASH if they are overweight or live with type 2 diabetes. 

Doctors treating patients with type 2 diabetes already have a lot to check on — eyes, kidneys, heart risks — but the British Liver Trust recommends that they should also not neglect the liver.  

If you are diagnosed with NAFLD or NASH, losing weight and eating a healthy diet is also the first line of treatment. Professor Stephen Ryder explains, “There is good evidence that losing 10% of body weight can control and, in some cases, reverse the condition.” 

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