Fatty liver disease—now known in medical terms as metabolic dysfunction‑associated steatotic liver disease (MASLD)—is on the rise, especially among people who are overweight, diabetic, or have metabolic syndrome. While early stages may appear harmless or even symptomless, experts warn that if left untreated, fatty liver can progress to metabolic dysfunction‑associated steatohepatitis (MASH)—a more serious condition involving inflammation and liver damage. This progression can significantly increase the risk of hepatocellular carcinoma (HCC), the most common form of liver cancer according to a a report by MD Anderson Cancer Center, University of Texas. Fortunately, early detection and lifestyle interventions can often reverse the condition before it becomes life-threatening.
What is MASLD and how does it lead to cancer?
MASLD refers to fat accumulation in the liver in individuals who consume little or no alcohol. When this condition progresses to MASH, inflammation and damage to liver cells occur. Over time, this can result in fibrosis (scarring) and eventually cirrhosis, both of which are known risk factors for liver cancer. Even in cases where cirrhosis hasn’t yet developed, the presence of MASH significantly increases cancer risk due to chronic inflammation and cellular damage in the liver.
How lifestyle affects your risk
Your daily habits play a major role in whether fatty liver progresses to cancer. People with unhealthy diets, sedentary lifestyles, and poor sleep quality are more likely to develop MASLD. On the flip side, those who engage in regular physical activity, maintain a healthy weight, and follow a balanced diet are much less likely to develop advanced liver disease. Diets high in processed foods, red meat, and added sugars tend to worsen liver health, while plant-based foods and whole grains can help protect it.
Who is at high risk?
Certain individuals are more likely to develop fatty liver disease and face increased cancer risk, including those who:
- Are overweight or obese, especially with abdominal fat
- Have type 2 diabetes
- Suffer from high cholesterol or triglycerides
- Have high blood pressure
- Are diagnosed with metabolic syndrome
- Have a family history of liver disease
Millions of people worldwide may have MASLD or MASH without knowing it, putting them at risk for complications, including liver cancer.
Warning signs your liver may be affected
Fatty liver disease is often called a “silent” condition because many people do not notice symptoms until the disease has advanced. However, some potential warning signs include:
- Chronic fatigue or weakness
- Discomfort or pain in the upper right side of the abdomen
- Elevated liver enzymes on blood tests
- Enlarged liver detectable by imaging
- Unexplained weight loss (in more advanced stages)
Because symptoms often appear late, routine screening is important for high-risk individuals.
How to reduce risk and protect your liver
The good news is that fatty liver disease is often preventable—and even reversible in early stages. The following strategies can significantly reduce your risk:
- Maintain a healthy weight: Losing just 5–10% of body weight can have a major impact on liver health.
- Adopt a balanced diet: Emphasize vegetables, fruits, legumes, whole grains, lean protein, and healthy fats.
- Exercise regularly: Aim for at least 150 minutes of moderate-intensity activity per week.
- Prioritize quality sleep: Lack of sleep can worsen insulin resistance and weight gain.
- Avoid alcohol and tobacco: Both contribute to liver inflammation and damage.
- Manage blood sugar and cholesterol: Through diet, exercise, or medications as needed.
- Seek medical guidance: Ask your doctor about liver screening if you have risk factors. New treatments, including weight-loss medications, may also be helpful.
Fatty liver disease is more than just fat in the liver—it’s a growing health crisis with serious long-term consequences, including liver cancer. The progression from MASLD to MASH to liver cancer can occur quietly, but it can often be stopped or even reversed through timely intervention. With regular checkups, awareness of symptoms, and simple lifestyle changes, you can protect your liver and reduce your risk of life-threatening complications. If you’re at risk, don’t wait—speak with your doctor and take action today.
