It's also known as metabolic dysfunction-associated steatotic liver disease (MASLD).
Symptoms of non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease does not usually cause any symptoms.
Many people have it without realising. It's usually found when you have tests for another reason.
Some people have symptoms including:
- feeling very tired
- feeling generally unwell
- liver pain or discomfort, which is felt in your tummy (abdomen) under the right side of your ribs
Who is more likely to get non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease is very common.
You're more likely to get it if you:
- are overweight, particularly if you have a lot of fat around your stomach and waist
- do not have a healthy diet or are not very physically active
- have type 2 diabetes
- have polycystic ovary syndrome
- have high blood pressure or high cholesterol
- are over 50
Non-urgent advice: See a GP if:
- you think you could have non-alcoholic fatty liver disease
- you think you have a higher risk of getting non-alcoholic fatty liver disease
How non-alcoholic fatty liver disease is diagnosed
Non-alcoholic fatty liver disease is usually diagnosed after blood tests or scans are done for another reason, and the results show signs of problems with your liver.
If a GP thinks you could have non-alcoholic fatty liver disease, or if tests show signs of liver problems, the GP will ask about your symptoms and check your height, weight and waist measurement. They'll also ask about how much alcohol you drink, to rule out alcohol-related liver disease.
They may arrange more blood tests, and sometimes scans such as an ultrasound scan of your tummy, to:
- confirm if there's a build-up of fat in your liver
- rule out other causes of liver problems
- find out if there's any damage to your liver
- check for other conditions linked to non-alcoholic fatty liver disease, such as kidney problems
Stages of non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease has 4 stages.
Most people only have the 1st stage, which does not usually cause any problems. A small number of people will progress to the later stages with more serious liver damage, but lifestyle changes can help prevent this.
| Stage | What this means |
|---|---|
|
1: Fatty liver (steatosis) |
The 1st stage, where there is build-up of fat but no damage to your liver |
|
2: Non-alcoholic steatohepatitis (NASH) |
A build-up of fat has caused inflammation in your liver. It is not yet seriously damaged, but there's a risk it could get worse |
|
3: Fibrosis |
There is damage to your liver, but it will usually still be working well. It's important to try to stop further damage which could lead to cirrhosis |
|
4: Cirrhosis |
There is severe damage to your liver that will affect how well it works. This could cause serious health problems including internal bleeding, liver failure, liver cancer or sepsis |
How you can treat non-alcoholic fatty liver disease yourself
If you have non-alcoholic fatty liver disease, healthy lifestyle changes can reduce the build-up of fat in your liver and help repair any damage or stop it getting worse. Your GP can give you advice about this.
These changes will also reduce the risk of some other conditions that are linked to non-alcoholic fatty liver disease, including cardiovascular disease, chronic kidney disease, high blood pressure and type 2 diabetes.
Do
-
eat a healthy, balanced diet
-
exercise regularly – aim to do at least 150 minutes of exercise a week
-
lose weight if you're overweight
Don’t
-
do not drink too much alcohol – keep to the recommended limit of no more than 14 alcohol units a week
-
do not smoke
NHS help to get healthy
NHS Better Health has free tools and support to help you have a healthy diet, lose weight and get active.
Treatment for non-alcoholic fatty liver disease from a GP or specialist
If you have non-alcoholic fatty liver disease, apart from making healthy lifestyle changes you will not need any other treatment unless your condition has progressed and you have damage to your liver.
You should have check-ups as least once a year and tests every 2 to 3 years to monitor your condition.
If you have damage to your liver (fibrosis or cirrhosis), as well as making healthy lifestyle changes you'll need to see a liver specialist in hospital for treatment.
Treatment from a liver specialist may include a medicine called pioglitazone, or vitamin E. In very severe cases you may need a liver transplant.
If you're living with obesity a specialist may recommend treatments to help with weight loss such as medicines or surgery.
Help and support for non-alcoholic fatty liver disease
If you have non-alcoholic fatty liver disease, you will be supported by your GP or specialists.
There are also national charities that offer support and information about non-alcoholic fatty liver disease.
British Liver Trust
Information and support for people affected by liver disease.
Page last reviewed: 31 July 2025
Next review due: 31 July 2028