Nonalcoholic steatohepatitis (NASH) is a serious liver disease that has become more common in recent years. Understanding NASH is crucial for early detection, effective management, and improved health outcomes.1
There are several common misconceptions about NASH and other liver conditions. But it is vital to separate fact from fiction.
Myth: Only people who drink alcohol get NASH and other liver diseases
One of the most common myths about NASH is that it affects only people who drink a lot of alcohol. This is false. NASH is a type of nonalcoholic fatty liver disease (NAFLD). In these conditions, fat builds up in the liver of people who drink little to no alcohol.2
Unlike alcohol-related liver disease, NASH 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: NASH and NAFLD are the same disease
While NASH and NAFLD are related, they are 2 distinct liver diseases. Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for a range of liver conditions. NASH and nonalcoholic fatty liver (NAFL) are both types of NAFLD.2
NASH is the most severe form of NAFLD. With NASH, fat buildup in the liver leads to inflammation and liver cell damage. If left untreated, NASH can result in complications like:2
- Scarring of the liver (fibrosis)
- Permanent scarring of the liver (cirrhosis)
- Liver failure
- Liver cancer
Myth: NASH is rare
NASH 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 NAFLD, with some of them developing NASH.1-3
Overall, lifestyles are becoming more sedentary and diets are becoming less healthy. With these trends, rates of NAFLD and NASH are expected to continue rising.1-3
Myth: Only people with obesity get NASH
Although obesity is a major risk factor for NASH, it is not the only one. NASH 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 NASH based on their genes.4
Myth: NASH is easily diagnosed
Unfortunately, diagnosing NASH is not straightforward. Many people with NASH 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 NASH
There are many effective treatment options for NASH. Lifestyle changes, such as losing weight, eating a healthy diet, and getting regular exercise, can improve liver health and slow the progression of NASH. 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 NASH. In 2024, a drug called resmetirom (Rezdiffra™) was approved to treat adults with NASH 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 NASH.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 NASH, ask your liver care team. They are a valuable resource and can answer any questions you may have.