MASLD vs NAFLD: What the Name Change Means for Patients
Why the medical community renamed NAFLD to MASLD (and NASH to MASH) — what's different, what's the same, and what it means if you've already been diagnosed.
If you were diagnosed with non-alcoholic fatty liver disease (NAFLD) any time before 2023, you might now be hearing your doctor or your liver report use a different term: MASLD, or sometimes MAFLD. This article explains what changed, why, and what it means for you.
What changed in 2023
In June 2023, an international expert panel published new nomenclature in the Journal of Hepatology and Hepatology. The change was driven by two main concerns: (1) defining a disease by what it isn't ('non-alcoholic') is unusual in medicine, and (2) the term carried stigma without describing the actual underlying cause.
The new framework: MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease) replaces NAFLD. MASH (Metabolic dysfunction-Associated Steatohepatitis) replaces NASH — the inflammatory form. MAFLD is a closely related term that some clinicians still use.
What stayed the same
The underlying condition is essentially unchanged. If you had NAFLD before, you almost certainly have MASLD now. The risk factors, the natural history, the staging system (F0–F4 fibrosis), and the treatment approach are all the same.
More than 99% of patients previously diagnosed with NAFLD meet the new MASLD criteria. The change is primarily about clearer language, not a new disease.
Why the new terms are clearer
MASLD explicitly identifies the metabolic dysfunction underlying the disease — usually one or more of: type 2 diabetes, obesity, elevated waist circumference, high blood pressure, abnormal cholesterol, or pre-diabetes. This is more accurate than 'not alcohol-related,' because the metabolic driver is what actually causes the liver injury in most patients.
It also separates more cleanly from alcohol-related liver disease, and creates a new combined category — MetALD — for patients who have both metabolic risk factors and meaningful alcohol intake.
What it means for your care
Practically: nothing in your treatment plan changes because of the name. If your GP or specialist is using FIB-4 scores, liver elastography (kPa measurements), or imaging to monitor your liver, all of that continues exactly the same way.
If you're confused by mixed terminology in your reports (some old documents may still say NAFLD, newer ones may say MASLD), it's worth asking your doctor to clarify — but the underlying condition is the same.