Fatty Liver Disease (MASLD) and Liver Elastography (FibroScan)

Fatty liver disease is now the most common liver condition we see. Many people learn they have it by accident, from a routine blood test or an ultrasound done for another reason. The good news: it can be found early with a quick, painless test in our office, and for the first time there are FDA-approved medicines for people whose liver has started to scar.

What is fatty liver disease?

Fatty liver disease means extra fat has built up inside the liver. Doctors now call it MASLD (metabolic dysfunction–associated steatotic liver disease). You may also see the older name, NAFLD.

In some people, the fat leads to inflammation and injury of liver cells. This more active form is called MASH (formerly NASH). Over years, MASH can cause scarring (fibrosis), which can progress to cirrhosis, liver failure, or liver cancer.

You are more likely to have fatty liver disease if you have:

• Excess weight, especially around the waist
• Type 2 diabetes or prediabetes
• High blood pressure
• High triglycerides or low HDL (“good”) cholesterol

It can also happen in people who are not overweight. Asian Americans in particular can develop fatty liver disease at a lower body weight, so it is worth checking even if your weight is normal.

Most people have no symptoms until the liver is badly scarred. That is why testing matters.

How we check your liver: liver elastography (FibroScan)

Liver elastography, often called a FibroScan, is an ultrasound-based test that measures two things:

• Liver stiffness, which shows how much scarring (fibrosis) is present. A stiffer liver means more scarring.
• A fat score, which estimates how much fat is in the liver.

The test does not hurt and uses no needles or radiation. You lie on your back while a small probe rests on the skin over your liver. You may feel a light tap or vibration.

We perform liver elastography at our Temple City office. Do not eat or drink for 3 hours before the test. Read the full liver elastography instructions (also in Español, Tiếng Việt, and 中文).

Your doctor will review the results together with your blood tests, such as liver enzymes and the FIB-4 score. Most patients do not need a liver biopsy, but your doctor may recommend one if the results are unclear.

Treatment options

1. Lifestyle changes: still the foundation

Losing weight is the most effective way to reduce liver fat. Losing about 5% of your body weight lowers liver fat, and losing 7–10% can calm inflammation and even improve scarring. Other steps that help:

• Eat more vegetables, beans, whole grains, and fish; cut back on sugary drinks, refined carbohydrates, and fried foods
• Stay active: aim for about 150 minutes of moderate exercise each week
• Limit or avoid alcohol
• Keep diabetes, blood pressure, and cholesterol under control

2. Rezdiffra (resmetirom)

Rezdiffra is a once-daily pill. In March 2024 it became the first medicine FDA-approved for adults with MASH and moderate to advanced liver scarring who do not have cirrhosis. It is used together with diet and exercise. It works directly in the liver, helping it burn fat.

In the study that led to approval, about a quarter to a third of patients taking Rezdiffra for one year had their MASH resolve, compared with about 1 in 10 on placebo. More patients on Rezdiffra also had less scarring. Research in people who already have cirrhosis is ongoing.

3. Wegovy (semaglutide)

Wegovy is a once-weekly injection, first approved for weight loss. In August 2025 the FDA also approved it for adults with MASH and moderate to advanced liver scarring. In its study, 63% of people on Wegovy had their MASH resolve after about a year and a half, compared with 34% on placebo. Scarring improved in 37% compared with 22%. The study continues, to learn whether Wegovy lowers the risk of cirrhosis and other serious liver problems over time.

4. Zepbound (tirzepatide)

Zepbound is a once-weekly injection approved for weight management and obstructive sleep apnea. It is not FDA-approved for fatty liver disease, but because it leads to significant weight loss, doctors sometimes use it “off label” for selected patients. In an early study published in 2024, most people taking tirzepatide for one year had their MASH resolve, compared with a small fraction on placebo. A large study that began in 2025 is now testing whether it prevents serious liver problems.

Each of these medicines has possible side effects, interactions with other drugs, and insurance coverage rules. We will help you decide which option, if any, fits your health and your plan.

5. Clinical trials

Our practice is preparing to offer clinical trials for fatty liver disease. See our Clinical Trials page to learn more.

When should you see a gastroenterologist?

• Your liver enzymes (ALT or AST) are high
• An ultrasound, CT, or MRI showed fatty liver
• You have type 2 diabetes or obesity, especially with a family history of liver disease
• You have been told you may have liver scarring or cirrhosis

Make an appointment

Our gastroenterologists in Temple City care for patients from Arcadia, San Gabriel, Pasadena, Monrovia, Monterey Park, and across the San Gabriel Valley. We accept most PPO plans (see accepted insurances), and our doctors speak English, Vietnamese, and Mandarin. Schedule an appointment or call 626-898-4560.

This article is for general education and is not a substitute for medical advice. Talk with your doctor about your own health.