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August 2025
In this engaging episode from the GHAPP MASLD Community Network, Alison Moe shares practical insights into the most common questions patients ask about advanced fibrosis and fatty liver disease. Using a liver model, she explains the stages from normal liver to steatosis, fibrosis, and cirrhosis, emphasizing that with lifestyle modifications—such as weight loss, glycemic control, and now FDA-approved pharmacotherapy—fatty liver disease, including F3 fibrosis, can be reversible. Alison also addresses a critical concern: alcohol consumption. She breaks down how her guidance differs depending on the presence and stage of fibrosis, adhering to strict AASLD guidelines to protect liver health. Whether you're a healthcare provider or a patient looking for clarity, this video offers evidence-based guidance and compassionate answers.
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Common Questions from Community GI About MASH
July 2025
In this practical and timely video, Erin Tanner, NP at Gastro Health in Birmingham, Alabama, shares expert insights on how community gastroenterology providers should approach incidental findings of fatty liver (MASLD/MASH) on abdominal imaging. With over 14 years of experience in GI and hepatology, Erin emphasizes that fatty liver can no longer be ignored, even when discovered during workups for unrelated GI symptoms like reflux or diarrhea. She walks through the step-by-step use of the FIB-4 index to risk-stratify patients and explains when to follow up with further non-invasive testing such as FibroScan® or ultrasound elastography. For patients with F3 fibrosis, Erin outlines next steps including lifestyle interventions, the use of Resmetirom, and the promise of GLP-1 therapies for future treatment. This is a must-watch for GI clinicians aiming to improve outcomes by proactively managing fatty liver disease in everyday practice.
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Common Questions From Primary Care Providers About MASH
July 2025
In this concise and practical discussion, Lindsay Pratt, PA-C from the University of Colorado’s Department of Hepatology and Liver Transplant, shares expert guidance on screening and managing patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). Speaking directly to the common questions she receives from primary care providers, Lindsay outlines when to screen for MASLD/MASH—emphasizing the importance of evaluating patients with elevated liver enzymes, hepatic steatosis on imaging, and cardiometabolic risk factors like diabetes, hypertension, hyperlipidemia, and sleep apnea. She breaks down the utility of FIB-4 as a first-line non-invasive test, when to use FibroScan®, and clears up a common misconception about statin use in liver disease—encouraging providers to continue or initiate statins when indicated. This session is ideal for clinicians managing metabolic syndrome and its liver manifestations and offers simple, evidence-based tools to identify at-risk patients early.
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APP Insights: Common Questions from Community GI About MASH
June 2025
In this video, Lindsay Yoder, PA-C, a hepatology expert at Indiana University in Indianapolis, addresses some of the most common questions general GI providers have about diagnosing and managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). She explains the nuance of interpreting positive autoantibodies like ANA or ASMA, emphasizing that up to 30% of patients with MASLD/MASH may have non-specific reactive antibodies that are not clinically significant for autoimmune hepatitis. Lindsay walks viewers through how to evaluate serologic workups in context—considering IGG levels, ALT trends, and symptoms like fatigue or pruritus—and when to consider liver biopsy. She also shares expert guidance on when to refer patients to hepatology, particularly those with advancing fibrosis (F2-F4) or cirrhosis. Finally, she clarifies how to distinguish between MASLD and alcohol-associated liver disease (ALD), using daily alcohol consumption levels alongside cardiometabolic risk factors to help determine whether a patient falls into a MASLD, ALD, or mixed-etiology category like MetALD. This informative session is essential viewing for clinicians navigating the evolving landscape of metabolic liver disease.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD and MASH Community Network, Tessa Janovsky, PA-C at Arizona Liver Health, answers common questions from primary care providers about Metabolic Dysfunction–Associated Steatohepatitis (MASH) and its updated terminology. She explains why MASH has replaced the term NASH, highlighting the shift to reflect underlying metabolic drivers such as obesity and type 2 diabetes while removing stigmatizing language. Tessa discusses how normal or mildly elevated liver enzymes do not rule out MASH, the importance of screening high-risk groups—including patients with diabetes, obesity, metabolic syndrome, or incidental fatty liver on imaging—and why the FIB-4 score is the preferred first-line test for fibrosis risk assessment. She also reviews the first FDA-approved medication for MASH, resmetirom, as well as the role of GLP-1 therapies and upcoming treatment options. Whether you’re a clinician seeking updated screening guidelines or a patient wanting clarity on diagnosis and management, this session provides clear, evidence-based guidance on identifying and treating MASH.
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Common Questions from Primary Care Providers About MASH
July 2025
In this educational video, Robin Soto, RN, MSN, FNP-BC from UC San Diego Health, answers common questions from primary care providers about the progression and management of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She addresses the often-misunderstood reality that fatty liver disease can progress to cirrhosis, even in patients with no history of alcohol use—challenging the stigma that surrounds liver disease. Robin explains how MASH is a progressive condition, and if left unmanaged, can lead to advanced fibrosis and liver failure. She also shares practical dietary advice for patients, highlighting the benefits of the Mediterranean diet—rich in healthy fats, fiber, and low in processed foods and sugars—as recommended by hepatology societies like AASLD. Importantly, she emphasizes that even modest weight loss (3–10%) can significantly improve steatosis, inflammation, and even reverse fibrosis. This video is a valuable resource for clinicians and patients alike, focused on prevention, early intervention, and empowering lifestyle changes.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this video, Jonathan Yeh, PA, answers three of the most frequently asked questions about MASH—Metabolic Dysfunction–Associated Steatohepatitis—and offers practical advice for understanding and managing this progressive form of fatty liver disease. He begins by explaining what MASH is: an inflammatory, more advanced stage of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), driven by abnormal fat accumulation in the liver due to impaired fat transport. Jonathan then breaks down the treatment approach, emphasizing the importance of lifestyle modification—particularly diet and exercise. He highlights the benefits of a green Mediterranean diet, regular physical activity, and sustainable weight loss, which can improve or even reverse MASH in many patients. For individuals with more advanced fibrosis, pharmacologic treatment with resmetirom (Rezdiffra) may be indicated. This concise FAQ offers helpful guidance for patients and providers alike on tackling MASH with evidence-based strategies.
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Misconceptions About Liver Health
July 2025
In this quick but powerful video, Jeremy Davis, NP from Shreveport, Louisiana, addresses some of the most common misconceptions about liver health that he encounters in clinical practice. Many patients believe that liver disease only occurs in people who drink alcohol, but Jeremy explains how conditions like MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis) can affect individuals regardless of alcohol use. He also clears up the myth that only overweight patients are at risk, pointing out that co-morbidities such as hypertension, high cholesterol, cardiovascular disease, and type 2 diabetes can contribute to liver disease—even in patients with a normal BMI. Finally, Jeremy explains why normal liver enzyme labs (ALT and AST) don’t always rule out liver disease, making it crucial to assess underlying risk factors and improve provider and patient awareness. This video is a valuable resource for both healthcare professionals and patients looking to better understand non-alcoholic liver disease and why early screening matters.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Kelly Smeester, PA-C from South Denver Gastroenterology, addresses some of the most common and harmful misconceptions about liver health. One major myth she tackles is the belief that liver disease only affects those who drink excessive amounts of alcohol. Kelly explains that liver disease has many causes—including autoimmune conditions, viral infections, and metabolic dysfunction—meaning even individuals who don’t drink at all may still be at risk. She emphasizes the dangers of relying on unregulated “liver detox” supplements, clarifying that the liver is a natural detox organ and doesn’t require external cleanses, which may actually do more harm than good. Kelly also highlights how liver disease can be entirely asymptomatic, particularly in patients with conditions like type 2 diabetes, obesity, hypertension, and high cholesterol. Finally, she reinforces that cirrhosis is not solely alcohol-related and can result from steatotic liver disease, making regular liver evaluations and screenings crucial for early detection and management. This video is an essential resource for patients and providers aiming to better understand liver health beyond outdated myths.
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Common Questions from Patients About MASH
July 2025
In this impactful episode, Sherona Bau, NP from UCLA, addresses the most frequent and pressing questions patients ask after being diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease) or MASH (Metabolic-associated steatohepatitis)—including concerns about life expectancy, risk of liver failure, liver cancer, and genetic impact on family members. She emphasizes the importance of risk stratification using non-invasive testing, particularly FibroScan®, to determine the extent of fat accumulation and liver fibrosis. Sherona explains that early identification of stage 2 or 3 fibrosis is critical, as treatment options are now available for these stages, offering hope for patients. She also stresses that MASLD is not just a liver disease—it's a systemic, metabolic condition—and encourages coordinated care with endocrinologists, cardiologists, and dietitians. Additionally, she discusses the hereditary nature of fatty liver and the importance of family screening, especially for children of affected individuals. This video offers clear, compassionate guidance for patients and providers navigating the complexities of fatty liver disease.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD Community Network episode, Edith Johannes, NP at UCLA Health, shares evidence-based guidance on one of the most important questions in managing Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction–Associated Steatohepatitis (MASH): how much weight loss is needed to improve liver health. Drawing on years of experience in hepatology and liver transplant care, Edith explains how weight loss can reduce liver fat (steatosis), decrease inflammation, improve or even reverse fibrosis, and support better overall metabolic health. Research shows that achieving more than 10% weight loss can result in 100% improvement in steatosis, MASH resolution in 90% of patients, and fibrosis regression in over 80%. Even smaller amounts of weight loss—5% to 10%—provide significant liver and metabolic benefits, while exercise and dietary changes can help improve liver function even without weight loss. Edith also discusses when additional treatments like GLP-1s, bariatric surgery, or resmetirom may be needed. This video is essential for healthcare providers, patients, and caregivers seeking practical, science-backed strategies to manage MASLD and MASH effectively.
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