To focus solely on NAFLD nomenclature, not patient care, is ‘ultimately detrimental’
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This exercise about nonalcoholic fatty liver disease nomenclature is a distraction from what patients really care about.
Patients are most interested in being correctly identified as having NAFLD or nonalcoholic steatohepatitis rather than being told they have just a little fatty liver and don’t worry about it. Patients are also interested in having a treatment approved, or, at least at this point, being cared for in a meaningful, engaged way with active monitoring and access to the tools we have — everything from a coach to a bariatric surgery consult, and many things in between, including weight loss medications and control of cholesterol and diabetes.
There are so many things that can be done if patients are taken seriously with whatever stage of fatty liver disease or NASH they have. That’s what patients care about — not what it’s called.
It is exciting that there is so much research on this disease that is rapidly evolving. We understand that there are people with lower BMI who have lean NASH, for example, and there are different genetic predispositions that put people of Hispanic or Asian descent at increased risk. Those are all important things to learn, and someday it may be enough to be reflective of a name change or a change in the nomenclature.
But we have this one moment in time to introduce this condition to people and policymakers and to get primary care doctors interested and convinced that it’s really simple: It’s not a big lift to add this to the care they’re giving, and anything that doesn’t relate to that is ultimately detrimental. This is not what we should be focused on.
There are issues that have been brought up as justification, such as stigma. The truth is there’s stigma for all liver diseases. It’s the reason I drive a hepatic burgundy car with a liver-lady license plate — to get beyond the stigma. The term fatty liver disease or NAFLD is not enough to warrant all the changes in resources that would take away from finding treatment or giving people care.
- For more information:
- Donna R. Cryer, JD, is CEO of the Global Liver Institute.
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