Urgent action needed as new research reveals gaps in fatty liver disease diagnosis and care

New research released to coincide with Global Fatty Liver Day has found that fatty liver disease is being consistently overlooked, leading to late diagnosis. 

This discovery comes from analysis of a survey of patients with fatty liver disease, which found that more than half reported receiving no support following their diagnosis, and a third were diagnosed at a late stage.

Fatty liver disease, also known as MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease), is estimated to affect up to 1 in 5 people in the UK. The main risk factors are being overweight, an unhealthy diet or living with type 2 diabetes.

A survey conducted by the British Liver Trust found that among 687 people living with MASLD:

• 68% were overweight or obese

• 35% had type 2 diabetes

More than half (55%) said they had received no support with weight management, eating a healthy diet or physical activity, which is the cornerstone for successful treatment of this disease. In the early stages, reducing weight and improving diet can either halt disease progression or even reverse liver damage. 

Additionally, over a third of respondents said their diagnosis came at a late stage, when it was too late for effective treatment.

With an estimated two thirds of the UK population classed as overweight or obese, the charity is calling for better awareness among both the general population and healthcare professionals. The British Liver Trust is urging widespread, systematic case finding, including routine testing and liver scanning for people at risk—to enable earlier diagnosis and better outcomes. 

The charity also highlights the need for new treatments to be introduced alongside comprehensive education for healthcare professionals, to ensure patients receive appropriate support at the right time.

MASLD is affecting an increasing number of people across the UK. Mortality rates in England alone rose by 44% between 2019 and 2023, with the highest rates seen in the North of England.

Pamela Healy OBE, CEO at the British Liver Trust, told That's Health: “For too long, widespread misunderstandings around liver health have meant that large numbers of people are unaware of the risks to their liver from being overweight, or from eating too much unhealthy or ultra-processed food. People are frequently told how these lifestyle factors increase their risk of heart disease and type 2 diabetes, but the risk of fatty liver disease is rarely discussed.

“We want to see MASLD to be given the same attention as other major conditions, and we need effective changes to ensure that everyone at risk receives the right treatment at the right time.”

Sara’s father was told he had a fatty liver in 2014 and only received one scan in 2016. In 2024, he was diagnosed with MASLD and died just four months later in July 2024, aged 62. Sara and her family are still trying to come to terms with his tragic, and ultimately preventable, death: “If we’d got that MASLD diagnosis a little bit sooner, if he’d just had a few more weeks, and if he had been put under surveillance a few years earlier, they would have seen his liver was getting worse and it wouldn’t have got to this point.”

“MASLD is a growing public health concern across the UK,” said Professor Philip Newsome, a leading liver expert from King’s College Hospital London and medical advisor to the British Liver Trust. “We are seeing promising advances in research with several new treatments showing encouraging results. However, there is an urgent need to translate these developments into clinical practice, ensuring early detection and better treatments are embedded within the NHS to deliver real benefits for patients.”

https://britishlivertrust.org.uk

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The Curious Case of Fad Medical Diagnoses: Stress, Viruses, and Obesity

Medicine is a science, but it's also a product of its time. While human biology doesn’t change overnight, our understanding—and interpretation—of it often does. 

Over the decades, we've seen waves of what can only be described as fad medical diagnoses, where particular conditions become fashionable explanations for a broad spectrum of symptoms. 

At one time, it seemed every illness was caused by stress. Then, viruses took the blame. More recently, obesity has become the go-to culprit. But why do these diagnostic trends happen?

A Brief History of Blame

1. The Stress Epidemic (1970s–1990s)

In the late 20th century, as society became increasingly fast-paced, stress emerged as the catch-all diagnosis. From ulcers to insomnia, palpitations to headaches—everything was explained away as "just stress." While stress does have real physiological effects, its popularity as a blanket diagnosis often masked underlying issues. Mental health was poorly understood, and doctors lacked the tools or time to probe deeper.

2. The Virus Craze (1990s–2010s)

With the rise of better viral testing and media attention on outbreaks like swine flu, SARS, and Epstein-Barr, viruses became the next fashionable explanation. Vague, lingering illnesses like chronic fatigue syndrome or fibromyalgia were sometimes attributed to "post-viral" syndromes, even when no clear viral trigger was identified. It was often a medical shrug: "It must’ve been a virus."

3. The Obesity Blame Game (2010s–present)

As obesity levels rose globally and its links to chronic illness became undeniable, it began to overshadow other potential causes. Tired? Breathless? Achy joints? All too often, the patient hears, “Well, you need to lose weight.” 

While obesity is a risk factor for many conditions, the danger of overdiagnosing based on weight is that legitimate, unrelated issues might be missed, or dismissed entirely.

Why Does This Happen?

Time Pressure in Healthcare

Modern medicine often runs on tight schedules. GPs and consultants have limited time, and when a patient presents with nonspecific symptoms, it’s tempting to default to a commonly accepted explanation.

Lack of Diagnostic Certainty

Medicine doesn’t always have clear answers. When faced with a “mystery” illness, especially one that doesn’t fit textbook criteria, clinicians sometimes reach for diagnoses that feel safe, familiar, and broadly accepted.

Media and Public Perception

Popular health scares and media narratives shape both patient and doctor expectations. When stress, viruses, or obesity dominate headlines, they become part of the cultural consciousness—and diagnoses tend to follow.

Bias and Stigma

Sadly, stigma plays a role. Patients who are overweight or anxious may not receive the same level of investigative care, and their symptoms might be prematurely written off. This can lead to missed or delayed diagnoses.

The Risks of Fad Diagnoses

Misdiagnosis and Delayed Treatment: Patients may suffer longer because the real issue isn’t being addressed.

Erosion of Trust: Patients who feel dismissed may lose faith in the healthcare system, becoming less likely to seek help.

Overmedication or Undertreatment: Treating the wrong cause, such as prescribing antidepressants for stress when the issue is hormonal, can do more harm than good.

A Better Way Forward

Healthcare professionals and patients alike must be aware of the tendency toward diagnostic shortcuts. Good medicine demands curiosity, listening, and a willingness to dig deeper: Even when the answer isn’t obvious. Diagnostic trends will always exist, but critical thinking and personalised care must remain the gold standard.

Last notes:-

Just as fashion changes with the seasons, so too does the lens through which we view health. But while trousers can be swapped out easily, medical diagnoses affect lives. We must resist the urge to settle for convenient answers, and instead strive for accurate, compassionate, evidence-based care—no matter how “in vogue” a diagnosis might be.

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"Surrounded by Idiots?" Maybe It Is You…?

There’s a saying that pops up in moments of frustration: “I’m surrounded by idiots!” 

Whether muttered under your breath at work, shouted into a pillow after a tedious family gathering, or casually vented over a pint at the pub, it’s a phrase most of us have used.

But here’s the hard question:

What if the problem isn’t them… but you?

The Idiot Paradox

Let’s imagine a scenario. You go to work and nobody seems to understand your brilliant ideas.

 The drivers on the road are dangerously slow, or stupidly fast. The people in the shop queue can't operate the card machine. Your friends never quite get your jokes. Even your cat seems to be ignoring your commands.

At what point do you stop and ask:

Is it really possible that everyone else is wrong, all the time?

This isn’t to say you are the problem, but if the same issues repeat themselves across different settings, it’s worth a bit of healthy self-reflection.

The Dunning-Kruger Effect in Action

The Dunning-Kruger effect is a psychological phenomenon where people with low ability at a task overestimate their ability. In plain English: the less you know, the more confident you might feel. That could mean you’re mistaking your own gaps in knowledge for others’ incompetence.

It’s a humbling thought: And a powerful one.

Are You Communicating Clearly?

Sometimes, the issue isn’t about intelligence but communication. If people constantly misunderstand you, could it be that you’re speaking in jargon, rushing, or assuming shared knowledge?

Imagine turning up to a pub quiz and expecting everyone to know the capitals of obscure former Soviet states. If they don't, are they “idiots”? Or did you bring the wrong expectations?

The Control Freak Trap

Do you find yourself thinking, “If people would just do things my way, everything would work better”?

That’s a red flag. Wanting things done your way doesn’t make your way the best, it might just make you a bit of a tyrant in disguise.

Letting go of perfectionism and embracing the different (and often equally valid) ways people think and work can be liberating, and massively improve relationships.

Maybe You’re Just Tired

Honestly, if everyone seems like an idiot, you might simply be knackered. Exhaustion, stress, burnout, all can affect how tolerant, patient and forgiving we are. A good nap, a meal and a vent to a mate might bring the world back into balance.

Ask Yourself These Questions:

Do I hear the same feedback from different people?

Am I quick to judge others without giving them a fair chance?

Do I ever apologise when I get something wrong?

Could I explain this concept/idea to a 10-year-old? If not, is it actually that clever?

Do I assume good intentions, or immediately think people are being stupid or lazy?

Final Thoughts: It’s Not About Blame: It’s About Growth

This isn’t a call to self-flagellation. We all have moments where we lose patience. But if you’re always surrounded by idiots, take a breath and consider: could I be doing something differently?

Sometimes the most intelligent thing you can do is question your own assumptions.

And if after all that reflection you still think you’re surrounded by idiots… at least now you’ll know how to handle them more gracefully.

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