Surveying Stigma: MAFLD’s Nomenclature from Patient and Provider Perspectives

Non-alcoholic fatty liver disease (NAFLD) is estimated to affect 38% of adults worldwide, a statistic which is expected to increase with the rise of type 2 diabetes and obesity.
PUBLISHED IN: Journal of Hepatology (November 2023)


Despite the significant and growing burden it represents, awareness of NAFLD remains low amongst the global population and healthcare providers. This may be attributed to the stigma associated with its nomenclature, primarily stemming from terms such as “non-alcoholic” and “fatty”. A comprehensive understanding of this stigma, encompassing both patient and provider perspectives, is currently lacking.

This cross-sectional study aimed to investigate experiences and attitudes associated with NAFLD using two patient- and clinician-oriented, comprehensive surveys disseminated globally.

Key learnings:

Patient and provider responses varied by region. Of all 1976 patients who completed the survey, 48% reported that they had disclosed their diagnosis to family and friends. The term “fatty liver” was the most commonly used descriptor for their condition. Patients most commonly reported feeling neutral towards MAFLD’s nomenclature, although discomfort regarding the term “fatty liver disease” was noted amongst US and South Asian patients. Ultimately, patients felt that the term “obesity” was more stigmatising than “fatty”. In contrast, providers most commonly reported stigma for the terms “fatty” (38%) and “non-alcoholic” (34%), and emphasised difficulties in effectively communicating about MAFLD and its management via weight loss. These difficulties stemmed from patients’ lack of motivation to enact lifestyle changes as well as insufficient training in weight loss- and obesity-centred communication. These findings highlight a divergence between clinicians and patients regarding stigma and underscore the need for education to improve patient-provider dialogue.

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S Duarte, BSc

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