Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.

Surveys were completed by 1,976 patients with NAFLD across 23 countries and 825 healthcare providers across 25 countries.Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was “fatty liver” ；“metabolic disease” or “MAFLD” were rarely used. Regarding various diagnostic terms perceptions by patients, there were no substantial differences between “NAFLD”, “fatty liver disease (FLD)”, “NASH”, or “NAFLD”, “fatty liver disease (FLD)”, “NASH”, or “MAFLD”.

The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with “FLD” among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD.

Among providers, 38% believed that the term “fatty” was stigmatizing, while 34% believed that “nonalcoholic” was stigmatizing more commonly in MENA. 42% providers believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting “steatotic liver disease” as stigmatizing was low (14%). (Link)

Reference: Younossi, Z. M., Alqahtani, S. A., Alswat, K., Yilmaz, Y., Keklikkiran, C., Funuyet-Salas, J., ... & Lazarus, J. V. (2024). Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease. Journal of hepatology, 80(3), 419-430.