Evaluation of Stigma Toward Fatty Liver Disease

A recent Delphi statement proposed an adapted term from metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), substituting "fatty" with "steatotic", as the former was claimed to be stigmatizing. In this cross-sectional study, we aimed to investigate this and understand stigma and awareness among fatty liver disease patients.

A semi-structured interview consisting of questions was carried out with patients to get an understanding of their knowledge of fatty liver disease and their opinions on the terminology used for its diagnosis.

Surveys were completed by 222 fatty liver disease patients in a written questionnaire. Out of the participants, only 84 (37.8%) and 37 (16.7%) of patients believed that cirrhosis or hepatocellular carcinoma might result from fatty liver disease, while 82 (36.9%), 87 (39.2%), and 52 (23.4%) of patients thought fatty liver was connected to diabetes or cardiovascular disease. 189 individuals (85.1%) said that including the word "alcohol" in the name of a condition carries a stigma. Conversely, 177 (79.7%) of participants said that they do not consider the term "fatty" to be stigmatizing. Additionally, the degree of awareness of the disease's consequences seems very low. 159 (71.9%) and 180 (81.1%) participant expressed their lack of knowledge on how the disease can be diagnosed or treated, respectively, and 146 (65.8%) of the participants showed a desire to acquire knowledge about the impact of fatty liver disease on their well-being and health.

A part of our concern about fatty liver disease awareness without trivialization. The use of the word "fat" in the nomenclature of fatty liver disease linked with metabolic dysfunction is not perceived to be stigmatizing. The suggested change to MASLD does not seem warranted, at least if the stigma is the main concern.