A new study asked 321 health experts from 85 countries what’s the best way to fight fatty liver disease, a condition affecting one in three adults globally. The experts agreed on 15 proven strategies that governments and hospitals should use, with the top recommendation being to help people manage their weight, obesity, and type 2 diabetes. The study also found that checking for liver damage in people with diabetes is something that could make a real difference within the next five years. This research gives world health leaders a clear roadmap for tackling this growing health problem.

The Quick Take

  • What they studied: What are the most effective and practical ways to prevent and treat fatty liver disease on a global scale?
  • Who participated: 321 health experts and specialists from 85 different countries who work with liver disease and related health conditions
  • Key finding: All 15 recommended strategies received strong agreement (86% or higher) from experts worldwide, with managing weight and diabetes being the top priority (99% agreement)
  • What it means for you: If you have weight issues, diabetes, or are at risk for fatty liver disease, there are proven strategies that health systems should be using to help you. Talk to your doctor about screening and weight management options, though individual results vary based on your specific health situation.

The Research Details

Researchers gathered 15 evidence-based strategies for treating fatty liver disease by reviewing scientific literature. They then asked 321 health experts from around the world to evaluate these strategies based on how practical they are and how much they could help people. The experts voted on whether each strategy should be considered a priority for global health organizations like the WHO. This approach, called a Delphi study, helps find common ground among many experts on complex health issues.

The study focused on two related conditions: MASLD (metabolic dysfunction-associated steatotic liver disease), which is when fat builds up in the liver, and MASH (metabolic dysfunction-associated steatohepatitis), which is when that fatty liver becomes inflamed and damaged. The researchers also looked at which strategies could show real benefits within five years, not just in theory.

This research matters because fatty liver disease is extremely common but often overlooked by major health organizations. By getting agreement from experts worldwide, the study creates a strong case for governments and hospitals to prioritize these strategies. The focus on ‘quick wins’—things that can help within five years—makes the recommendations practical and actionable rather than just theoretical.

The study’s strength comes from its large, diverse panel of 321 experts across 85 countries, which means the recommendations reflect global perspectives rather than just one region’s viewpoint. The high level of agreement (all 15 strategies reached 86% or higher consensus) suggests these are well-established, evidence-based approaches. However, the study relies on expert opinion rather than testing these strategies in real-world settings, so implementation success may vary by country and healthcare system.

What the Results Show

All 15 proposed interventions achieved strong consensus among the expert panel, with combined agreement ranging from 86% to 99%. The highest-rated recommendation was managing overweight, obesity, and type 2 diabetes in people with fatty liver disease, receiving 99% agreement. This makes sense because these three conditions are closely connected—excess weight and diabetes both increase the risk of fatty liver disease.

The second major finding was that ‘routine screening for liver fibrosis in people with type 2 diabetes’ was the most endorsed quick buy, meaning experts believe this could make a real difference within five years. Fibrosis is scarring of the liver tissue, which is a sign that the disease is progressing. Catching it early through screening could help prevent serious complications.

The fact that 12 of the 15 interventions required some ‘somewhat agree’ responses to reach high consensus suggests that while experts support all recommendations, some are more straightforward to implement than others. The interventions cover a range of approaches, from lifestyle changes to medical treatments to public health policies.

Beyond the top recommendations, the study identified other important strategies including improving access to diagnostic tools, implementing public awareness campaigns about fatty liver disease, and integrating liver health into diabetes and obesity management programs. These secondary findings suggest that a comprehensive approach—combining individual medical care with public health efforts—is needed to address the problem effectively.

This study is significant because fatty liver disease has been largely absent from major global health agendas despite affecting one in three adults worldwide. Previous research has shown that weight loss, exercise, and managing diabetes help prevent fatty liver disease, but this study is the first to get global expert consensus on which strategies should be prioritized by governments and health organizations. It aligns with existing evidence about the importance of lifestyle factors while adding new emphasis on screening and early detection.

The study relies on expert opinion rather than testing these strategies in real-world healthcare systems, so actual implementation may face practical challenges not captured here. The experts may have biases based on their own countries’ healthcare systems and resources. Additionally, the study doesn’t provide detailed cost-effectiveness analysis, so it’s unclear which strategies offer the best value for money. Finally, while the study identifies what should be done, it doesn’t guarantee that countries will actually implement these recommendations.

The Bottom Line

If you have type 2 diabetes, are overweight, or have been diagnosed with fatty liver disease, work with your doctor on weight management and diabetes control—these are the most strongly supported interventions (very high confidence). Ask your doctor about screening for liver fibrosis if you have diabetes, as early detection can prevent serious complications (high confidence). For policymakers and health systems, prioritizing these 15 strategies in national health plans is recommended based on strong expert consensus (high confidence).

Anyone with type 2 diabetes, obesity, or metabolic syndrome should pay attention to these findings. Healthcare providers, hospital administrators, and government health officials should use this as a guide for policy decisions. People with a family history of liver disease or those who are overweight should also be aware. However, these recommendations are general guidelines—individual treatment plans should be developed with a healthcare provider based on personal health status.

Weight loss and improved diabetes control can show benefits for liver health within 3-6 months, though significant improvement in liver fibrosis may take 6-12 months or longer. Screening programs could identify at-risk individuals within months, but preventing disease progression requires sustained effort over years. The ‘quick buy’ designation suggests these strategies could show measurable public health impact within five years if widely implemented.

Want to Apply This Research?

  • Track weekly weight changes and blood sugar levels (if diabetic) to monitor progress toward the top-recommended intervention of managing weight and diabetes. Set a goal of losing 5-10% of body weight over 6 months, which research shows can improve liver health.
  • Use the app to log daily physical activity (aim for 150 minutes per week), track meals to support weight loss, and set reminders for diabetes medication if applicable. Create a reminder to schedule liver fibrosis screening with your doctor if you have type 2 diabetes.
  • Monitor weight trends monthly and blood sugar control quarterly. If using the app with healthcare provider integration, share reports showing progress on weight management and diabetes control. Schedule annual check-ins to discuss liver health screening, especially if you have diabetes or metabolic risk factors.

This research provides expert consensus on strategies for fatty liver disease but does not constitute medical advice. Individual treatment plans should be developed with a qualified healthcare provider based on personal health status, medical history, and risk factors. If you have been diagnosed with fatty liver disease, type 2 diabetes, or are overweight, consult your doctor before making significant lifestyle changes or starting new treatments. The recommendations in this study are intended for healthcare systems and policymakers as well as individuals; implementation and effectiveness may vary based on individual circumstances and healthcare access.