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“Re-branding” a disease: From NAFLD to MAFLD

March 25, 2021

Non-alcoholic fatty liver disease (NAFLD) is undergoing a brand refresh. Researchers believe that a re-classification of this disease, which affects nearly a billion people globally with no drug treatment currently on the market, is essential to improve patient understanding and industry funding to better mitigate its impact.

Experts recommend that NAFLD now be referred to as “metabolic (dysfunction)-associated fatty liver disease” (MAFLD). This change underscores the inherent metabolic dysfunction directly related to the disease and decreases the emphasis on alcohol (or lack thereof).

Why does the name matter?

In medical practice, whether in research studies or clinical treatment, nomenclature can affect how a disease is treated by patients, providers, and even health policy. According to a piece in Liver International, “this change…may be the first step that catalyzes the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery.” The rebranding will help increase patient and provider awareness and understanding of this disease and potentially alleviate the ever-increasing health crisis NAFLD is causing in communities across the world.

Leaving out the alcohol

The disease was first defined as “fatty liver in the absence of substantial alcohol intake.” Therefore, the current definition of NAFLD in guidelines and study recommendations frequently excludes other, often significant, causes of liver disease while including other less critical indicators. According to Liver International, “using the term ‘non-alcoholic’ to describe all fatty liver un-associated with alcohol consumption…leads to lumping together of likely a variety of distinct and (unrelated) conditions.”

For years, liver experts and researchers have pointed out that NAFLD doesn’t have much to do with alcohol. In fact, studies found that even moderate alcohol consumption was associated with a higher NAFLD-activity Score. Many people associate liver disease with excess drinking, which can make it difficult for them to understand the cause and consequences of the disease.

With the medical world’s increased knowledge of metabolic dysfunction in triggering NAFLD development, eliminating “alcohol” from the name and definition could lead to more inclusive criteria for the disease – rather than focusing on a “negative definition.”