Lilly direct-selling Zepbound at $499/mo — compare with 11 other programs →
WeighedHealth
Affiliate disclosure: we earn commission from some partners. Learn more.
Metabolic dysfunction-associated steatohepatitis (MASH) — illustrative hero

Metabolic dysfunction-associated steatohepatitis (MASH)

ICD-10 K75.81

Reviewed by the WeighedHealth Editorial Team against primary clinical sources — FDA labeling, peer-reviewed trials, and specialty-society guidelines.
Content current as of July 2026; updated when guidance or availability changes.
Last verified by WeighedHealth Editorial Team against primary sources
~0-30%
US adult MASLD prevalence
~0%
have MASH (progressive form)
0-10%
weight loss reverses MASH in most
04
Rezdiffra first FDA-approved MASH drug

What are the symptoms of metabolic dysfunction-associated steatohepatitis (mash)?

  • Most patients are asymptomatic — discovered on routine labs (elevated ALT/AST) or imaging
  • Vague right upper quadrant discomfort or fullness
  • Fatigue (non-specific)
  • Advanced fibrosis/cirrhosis symptoms: jaundice, ascites, easy bruising (late-stage only)

Who is at risk for metabolic dysfunction-associated steatohepatitis (mash)?

  • Obesity (BMI ≥30 — 75%+ of MASH patients are obese)
  • Type 2 diabetes or prediabetes
  • Hypertension
  • Dyslipidemia (especially high triglycerides)
  • Metabolic syndrome (3+ of the above)
  • Hispanic ancestry (higher US prevalence)
  • PCOS in women

How is metabolic dysfunction-associated steatohepatitis (mash) diagnosed?

Suspected when imaging (ultrasound, MRI-PDFF, or transient elastography) shows hepatic steatosis in adults with cardiometabolic risk factors. Confirmed historically by liver biopsy showing steatosis + lobular inflammation + ballooning hepatocytes. Newer non-invasive scoring (FIB-4, NAFLD fibrosis score, MAST score) increasingly supplants biopsy.

How is metabolic dysfunction-associated steatohepatitis (mash) treated?

Weight loss is the most evidence-supported intervention: 7-10% body weight loss reverses MASH in most patients. GLP-1 receptor agonists (semaglutide, tirzepatide) show histologic improvement in trials and are first-line where comorbid obesity or T2D exists. Resmetirom (Rezdiffra, FDA-approved 2024) is the first MASH-specific drug. Bariatric surgery for severe disease with concurrent severe obesity.

Medications used for metabolic dysfunction-associated steatohepatitis (mash)

Authority reference: www.aasld.org

Other conditions

glp1

Obesity

Obesity is a chronic disease defined by excess body fat that increases the risk of cardiovascular disease, type 2 diabetes, and other comorb

glp1

Type 2 diabetes

Type 2 diabetes (T2D) is a chronic metabolic disease characterized by insulin resistance and progressive beta-cell dysfunction, resulting in

glp1

Chronic kidney disease (CKD)

Chronic kidney disease is progressive loss of kidney function over months to years. Classified by estimated glomerular filtration rate (eGFR

ed

Erectile dysfunction

Erectile dysfunction (ED) is the persistent inability to attain or maintain an erection sufficient for satisfactory sexual performance. Prev

hair loss

Male-pattern hair loss (androgenetic alopecia)

Male-pattern hair loss (androgenetic alopecia) is the most common form of hair loss in men, affecting ~50% by age 50 and ~80% by age 70. Cau

skincare

Acne vulgaris

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, characterized by comedones, papules, pustules, and (in severe cas

mental health

Major depressive disorder

Major depressive disorder (MDD) is a chronic, recurrent mood disorder characterized by persistent low mood, loss of interest or pleasure (an

anxiety

Generalized anxiety disorder

Generalized anxiety disorder (GAD) is excessive, uncontrollable worry about everyday matters lasting ≥6 months, with at least 3 associated s

Related topics

Sources

Primary sources cited above. FDA labeling, peer-reviewed trials, and specialty-society guidelines only.

  1. Semaglutide in Patients with Cirrhotic and Non-Cirrhotic NASH (ESSENCE Phase 3 interim) · New England Journal of Medicine, 2024 · PMID 39718336
  2. Resmetirom for Nonalcoholic Steatohepatitis (MAESTRO-NASH) · New England Journal of Medicine, 2024 · PMID 38324483
  3. AASLD Practice Guidance on the Clinical Assessment and Management of NAFLD · Hepatology, 2023 · PMID 36926958

People also ask

  • What's the difference between MASLD and MASH?

    MASLD (metabolic dysfunction-associated steatotic liver disease) is the umbrella term for steatosis with metabolic risk factors — replaces the older NAFLD nomenclature. MASH (metabolic dysfunction-associated steatohepatitis) is the progressive form with active inflammation and hepatocyte ballooning, ~5% of MASLD patients. MASH carries fibrosis-progression risk; pure steatosis without MASH usually does not.

  • Will losing weight reverse my fatty liver?

    Yes — 7-10% sustained body-weight loss reverses MASH in most patients with concurrent improvement in fibrosis. GLP-1 receptor agonists (semaglutide, tirzepatide) produce this magnitude of weight loss reliably and have direct hepatic anti-inflammatory effects beyond the weight component in trials.

  • Is Rezdiffra (resmetirom) the same as a GLP-1?

    No. Rezdiffra (resmetirom) is a thyroid hormone receptor β agonist — a different mechanism. It's FDA-approved (2024) specifically for non-cirrhotic MASH with significant fibrosis. GLP-1s are not MASH-labeled but are increasingly used for the overlap of obesity, T2D, and MASH where weight loss is itself the treatment.

  • Should I avoid alcohol if I have MASH?

    Yes. MASH and alcohol-related liver disease are synergistic — even moderate alcohol amplifies MASH progression. Most hepatology guidance recommends abstinence or very minimal use (≤1 drink/week) in established MASH, particularly with any fibrosis.

Share: