Fatty liver disease affects 50 million Brazilian adults, medical data shows

An estimated 50 million Brazilian adults live with fatty liver disease, and at least 10 million suffer from metabolic dysfunction-associated steatohepatitis, or MASH, according to medical data discussed at the annual congress of the European Association for the Study of Diabetes in Milan, Italy. Portal Drauzio Varella reported that the condition often progresses silently without symptoms, making early diagnosis a major clinical challenge for healthcare providers.

European Congress Highlights Widespread Adult Prevalences Across Brazil

Global figures indicate an even broader impact, with a 2025 meta-analysis evaluating more than 11 million people estimating a worldwide prevalence of 37.5%, as reported by Estado de Minas. Costa Norte noted via the Sociedade Brasileira de Hepatologia that roughly 30% to 40% of the world's population has metabolic dysfunction-associated steatotic liver disease. Among specific high-risk groups, the prevalence climbs significantly higher.

Estado de Minas detailed similar findings from its meta-analysis review, noting that the proportion of affected individuals rises to 70.2% among people with type 2 diabetes and 70.7% for those with overweight or obesity. Flávia Feier, a liver transplant surgeon cited by Estado de Minas, emphasized that the condition should not be viewed as an insignificant finding when linked to metabolic risk factors. Portal Drauzio Varella quoted Fernanda Canedo, a hepatologist, gastroenterologist, and medical manager at Novo Nordisk, who stressed that liver fat serves as an indicator of visceral fat accumulation.

Recent updates in medical standards have changed how physicians assess patient risk. Estadão reported that the American Gastroenterological Association published new guidelines shifting the diagnostic focus away from simply identifying who has liver fat toward identifying who faces clinically significant fibrosis. Lilian Curvelo, a gastroenterologist and hepatologist at Einstein Hospital cited by Estadão, explained that scarring determines patient prognosis rather than fat alone.

Portal Drauzio Varella outlined the fibrotic progression from initial fat entry into liver cells leading to chronic inflammation, subsequent scarring, and potentially cirrhosis or liver cancer if left untreated. Canedo pointed out that medical understanding has evolved regarding these scars.

Até o processo de fibrose é dinâmico e até determinado momento a gente consegue reverter, desde que você diagnostique — o que é um grande gargalo —, e comece o tratamento adequado precocemente.

Portal Drauzio Varella

Estadão noted that evaluation tools include the Enhanced Liver Fibrosis blood test, though access to these diagnostic instruments remains uneven.

Obesity and Diet Trigger Liver Fat Accumulation

While overweight and obesity are primary risk factors, the condition also affects individuals due to pre-diabetes, type 2 diabetes, high cholesterol, triglycerides, genetic factors, or alcohol history. Fernanda Braga Albuquerque told Portal Drauzio Varella that abdominal fat accumulation promotes insulin resistance and fat storage in the liver. Roberta Chaves explained in Costa Norte reporting that the liver also manufactures fat from excess nutrients through lipogenesis, transforming carbohydrates and sugars into lipids, a process worsened by artificial fructose and sedentary habits.

Treatment foundations rely on individual care plans emphasizing lifestyle modifications. Albuquerque told Portal Drauzio Varella that balanced nutrition, regular physical activity, moderate or zero alcohol intake, and a sustainable weight reduction of 5% to 10% can decrease liver fat and inflammation. Estadão and Costa Norte confirmed that pharmaceutical options vary by region, with agents like resmetirom available in the United States, while semaglutide is an option in Brazil.

Next Phase of Medical Evaluation and Therapeutic Access

Healthcare providers continue to refine risk stratification and patient monitoring strategies. Estado de Minas reported that clinical researchers point to a wide window of opportunity for early intervention before irreversible injury occurs, though metabolic liver disease remains a growing indication for transplants at centers like the Hospital das Clínicas of USP. Clinical guidance emphasizes that pharmacological treatments like semaglutide serve as part of an individualized care plan rather than a replacement for lifestyle changes, as detailed by Portal Drauzio Varella. Ongoing clinical discussions center on expanding early diagnostic access and identifying patients with significant fibrosis before complications require advanced interventions.