How to Manage Liver Disease
A Guide to Living with MASH
Metabolic dysfunction-associated steatohepatitis (MASH), previously called NASH, is a type of liver disease that happens when too much fat builds up in the liver and causes inflammation. If left untreated, it can lead to scarring (fibrosis), cirrhosis and even liver cancer. The good news is that with the right steps, people can slow or even reverse the disease. Let's look at how to manage liver disease—specifically MASH—through medical treatments, lifestyle changes and supportive therapies.
Medical Treatments
Right now, there isn’t a single FDA-approved drug just for MASH. However, doctors often use treatments that target related conditions like diabetes, high cholesterol and obesity, since these are closely tied to liver disease.
Common Treatments
- GLP-1 medications (like semaglutide). Originally used for diabetes, they also help with weight loss and reducing liver fat.
- Pioglitazone. A diabetes drug that can improve liver inflammation.
- Vitamin E. Sometimes recommended for non-diabetic patients to reduce liver damage.
- Statins. Used to lower cholesterol, protecting both the heart and liver.
Doctors also check liver enzymes with blood tests, use imaging like FibroScan to check scarring, and monitor for liver cancer in advanced cases. Regular follow-ups are key for staying ahead of the disease.
Lifestyle Changes
When it comes to how to manage liver disease, lifestyle changes are the most powerful tool. Small, consistent steps can make a huge difference.
Weight Loss
Losing weight is the number one way to improve MASH. Research shows that:
- Losing 5–7% of body weight can reduce liver fat.
- Losing 10% or more may even reverse inflammation and scarring.
Even slow, steady weight loss is better than crash diets, which can make liver disease worse.
Healthy Eating
A balanced diet helps both the liver and overall health. Doctors often recommend:
- Mediterranean diet. Full of vegetables, fruits, fish, whole grains, olive oil and nuts.
- Cutting back on sugar and processed carbs. Avoid soda, candy and packaged snacks.
- Choosing lean protein. Chicken, fish, beans and lentils are great options.
Exercise
Physical activity reduces liver fat, even without major weight loss. Aim for:
- 150 minutes of moderate exercise per week (like brisk walking, cycling or swimming).
- Strength training to build muscle and improve blood sugar control.
Limit Alcohol
Even though MASH isn’t caused by alcohol, drinking can make liver damage worse. Doctors often suggest cutting it out completely or keeping it to a minimum.
Supportive Therapies
Managing MASH isn’t just about the liver, it’s about the whole body.
- Managing diabetes and heart health. Controlling blood sugar, cholesterol and blood pressure lowers stress on the liver.
- Counseling or support groups. Lifestyle changes are easier with encouragement and accountability.
- Bariatric surgery. For people with severe obesity, weight-loss surgery may help improve or even reverse liver disease.
Preventing Complications
To stop MASH from turning into advanced liver disease, long-term care is essential. Doctors may recommend:
- Vaccinations. Protecting against hepatitis A and B.
- Regular cancer screenings. Especially for those with scarring or cirrhosis.
- Avoiding unsafe supplements or medications. Some “natural" remedies can actually harm the liver.
The Bottom Line
Remember, the most important steps are in your control. Eating well, exercising regularly, losing weight and avoiding alcohol can all protect your liver. Medications for diabetes, cholesterol and other conditions may also help. With new treatments currently in development, the future looks brighter for people living with MASH.
By making small but steady changes and working closely with your healthcare team, it’s possible to stop liver damage in its tracks and live a healthier, longer life.