Is MASH Reversible?

Lifestyle changes and medications can stop MASH from getting worse and, in some cases, heal liver damage that has already happened.

“These interventions are fairly effective in stabilizing the progression of MASH and even possibly reversing the inflammation associated with MASH,” Dr. Karagozian says.

Lifestyle Changes

Lifestyle changes are the cornerstone of managing and potentially reversing MASH, whether a person is on medications or not.

Healthy Diet and Exercise 

A healthy eating pattern and regular physical activity can help you reach a healthier weight, and that combo has been shown to directly reduce liver inflammation, fat buildup, and fibrosis. You can reduce the amount of fat in your liver by losing 5 percent of your body weight, and you can heal existing scarring and potentially reverse MASH by losing 10 percent or more. For a 150-pound person, a 10-percent loss is 15 pounds.

Alcohol Intake 

Medications

Depending on how severe your MASH is, your doctor may also recommend medications to help reduce inflammation and scarring in your liver.

“Most clinical trials [for these medications] include patients with stage 2 and stage 3 fibrosis and show reversal of steatohepatitis and fibrosis in some patients,” Barritt says.

These medications include:

• Resmetirom (Rezdiffra) This oral medication directly reduces the amount of fat and inflammation in the liver, which can reverse damage. It works by binding to thyroid hormone receptor beta in the liver, which regulates the liver’s fat metabolism and inflammation. In clinical trials, up to 28 percent of patients who took resmetirom had less liver scarring within one year.
• Semaglutide (Wegovy) Semaglutide is an injectable GLP-1 agonist medication that’s often prescribed to treat diabetes and obesity. Now it’s also approved to treat MASH. The mechanisms that support weight loss and blood sugar control are also thought to help reduce inflammation in the liver and improve scarring.