NAFLD vs MASLD — what changed?
Last content review 2026-09-23
The short answer
NAFLD (non-alcoholic fatty liver disease) was defined by what it was not — it excluded alcohol. MASLD instead defines the condition by what it is: liver fat plus metabolic dysfunction. For most people previously labelled NAFLD, the diagnosis maps to MASLD; the underlying condition has not changed, the naming has.
What is happening?
In 2023 an international multi-society group replaced "fatty liver disease" with "steatotic liver disease" (SLD) as the umbrella term.
Under that umbrella sit MASLD (metabolic), MetALD (metabolic dysfunction with greater alcohol intake), ALD (alcohol-associated), and other specific causes such as drugs or genetic conditions.
The word "non-alcoholic" and the term "fatty" were retired partly because they were imprecise and partly because they were experienced as stigmatising.
Why does this matter?
Older reports, prescriptions and articles still say NAFLD, and patients often worry they have been given a different disease. Usually they have not.
The new framework makes it explicit that metabolic health — not simply the absence of alcohol — is what defines the common form.
What does the evidence say?
The change was formalised in the 2023 Delphi consensus published in Hepatology and adopted in the EASL–EASD–EASO 2024 guideline.
Studies comparing the definitions report substantial overlap between NAFLD and MASLD populations, though the two are not identical in every individual.
Key takeaway
If your old report says NAFLD and a new one says MASLD, this is almost always a change in terminology, not a new or worse disease.
Sources & references
Multi-society Delphi consensus group
A multi-society Delphi consensus statement on new fatty liver disease nomenclature (2023) · Consensus statement
View original sourceEASL, EASD and EASO
EASL–EASD–EASO Clinical Practice Guideline on MASLD (2024) · Clinical guideline
View original source
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