Estimated reading time: 6 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
People often think of the condition MASH as being a weight issue. MASH, which stands for metabolic dysfunction-associated steatohepatitis, is a liver condition that affects millions of people worldwide. MASH is a more severe form of another disease called MASLD, which used to be called NAFLD. A lot of different acronyms! What you need to know is that MASH is closely tied to obesity, type 2 diabetes, and metabolic disorders. This leads many people with the condition to think that weight loss is the end all be all when it comes to managing and potentially reversing the condition. But is that true? What are the best ways to treat this disorder? Here, PatientsLikeMe will explain why weight is so closely tied to MASH and what you can do to manage your health.
How MASH Affects the Body
MASH happens when fat builds up in the liver. This will lead to inflammation and damage over time. In advanced cases it can cause fibrosis (scarring) and even progress to cirrhosis, which is when the liver is heavily damaged by scarring. It is also sometimes called end-stage liver disease. MASH mostly affects the liver, but it is also linked to other health problems like heart disease, type 2 diabetes, and an increased risk of cancer. One of the key factors in MASH is adiposopathy, which is when fat tissue is not stored where it is supposed to be and is not functioning properly. When the body stores more energy than it can handle, fat builds up not just in fat cells but also in organs like the liver. This adds to metabolic problems and increases inflammation, which in turn makes MASH and other related conditions worse.
Why Weight Gain Plays a Big Role
Carrying too much body weight is one of the biggest risk factors for developing MASH. The condition MASLD, which leads to MASH, is found in 75% of people who are overweight and 90% of people with severe obesity. The liver is responsible for processing fats and sugars, but when there is an excess of fat in the body, it starts storing too much of it. Over time, this leads to fat building up in liver cells, which triggers inflammation and scarring.
Studies have shown that MASH and its complications are closely linked to body fat, even in people with normal body weight. This means that reducing fat through weight loss can significantly improve liver health. Weight loss not only reduces fat accumulation in the liver but also helps decrease inflammation and fibrosis. This in turn improves your overall metabolic function. Metabolic function is also known as metabolism and is the process of how your body turns what you eat and drink into energy.
Can Losing Weight Reverse MASH?
Yes. Research has shown that weight loss is one of the most effective treatments for MASH. Losing just 5% of body weight can help reduce fat in the liver. A 7% weight loss is associated with improvement in liver inflammation. For people with fibrosis, losing 10% or more of body weight has been shown to reverse liver scarring in up to 80% of patients. Even for people with severe liver damage, weight loss can help reduce complications. This includes lowering portal hypertension, which is high blood pressure in the liver, and improving insulin sensitivity. There are no current drug treatments that can fully reverse MASH, so lifestyle changes and weight loss are the most effective strategies.
Tips for Losing Weight
So how do you lose weight? Even if you have your sights set on this goal to help control MASH, many people still find it hard to actually drop the pounds! Let's lay out some basic building blocks you can start with.
1. Diet
It is always going to come back to the food you are putting in your body. Studies have found a Mediterranean diet is very effective at supporting liver health! This diet is rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. You should also try to limit processed foods, sugar, and both saturated and trans fats. High amounts of sugar and refined carbohydrates contribute to fat buildup in the liver. Saturated and trans fats are found in fried foods, processed meats, and certain oils. These fats can make liver inflammation worse. Finally - stay hydrated! Drinking plenty of water can help the liver function properly and support weight loss.
2. Physical Activity
You also need to get moving! Your goal should be to hit at least 150 minutes of exercise per week. It also helps to spread it out across multiple days. Activities like walking, cycling, swimming and strength training can help burn fat and improve your metabolism. If you feel up to it, studies have found that high-intensity interval training paired with diet can help improve liver health. You don't need to become a gym rat overnight! Simple movements every day will make a difference.
3. Medical Interventions
There are times when dieting and exercise alone are not enough. Some people end up needing medical intervention! Certain prescription drugs can help control appetite and aid in fat loss. The very popular class of medication known as GLP-1s are examples of these. Bariatric surgery is another option. For people with severe obesity, surgical options like gastric bypass or sleeve gastrectomy can help with weight loss and liver health. There are also endoscopic procedures that are less invasive. These also can help reduce stomach size and limit how much food you eat.
Long-Term Health
It does not end after you have lost weight! Keeping weight off is just as important as losing it. Studies suggest that maintaining weight loss for more than a year is needed to see long-term liver health benefits. Moreover, people with type 2 diabetes need to be especially careful, as they have a higher risk of liver disease. Any lifestyle change you make should be gradual and sustainable. That is the best way to make sure you don't slide back into old habits and regain weight.
Weight loss can reverse the effects of MASH. Although MASH is a serious liver condition, picking up some healthy habits early can help down the line! If you are able to lower your body fat, you can decrease liver inflammation, prevent fibrosis, and lower the risk of severe liver complications. A healthy diet and exercise are the foundation of any weight management plan. If need be, medical interventions like medications and surgery are also effective for people who need more support. Take proactive steps toward weight loss today!
Taking control of your health has never been easier with PatientsLikeMe, a platform that empowers you to manage your wellness journey proactively. PatientsLikeMe offers tools to track your symptoms, treatments, and outcomes, enabling you to make informed decisions and communicate better with your healthcare providers.