Dan Marino’s MASH diagnosis spotlights a growing liver-disease risk

Hall of Fame quarterback Dan Marino disclosed that he was diagnosed with metabolic dysfunction-associated steatohepatitis, or MASH, a form of fatty liver disease that combines fat buildup with inflammation and liver-cell damage. The revelation brings attention to a condition that often progresses quietly and can develop without obvious symptoms for years. Medical experts say Marino’s case reflects a broader public-health concern tied to rising rates of obesity, type 2 diabetes, high cholesterol and hypertension.

MASH is viewed as a more dangerous development on the spectrum of fatty liver disease. It typically evolves from metabolic dysfunction-associated steatotic liver disease, or MASLD, where fat is present in the liver but inflammation is minimal. When inflammation and injury accompany fat buildup, the condition is classified as MASH, and that shift can increase the risk of fibrosis, cirrhosis and liver failure if not addressed. Doctors describe MASH as a “silent” disease in early stages, with fatigue, abdominal discomfort or jaundice often appearing only after substantial damage has occurred.

Global health experts estimate that roughly 1.5% to 6.5% of people worldwide have some form of this disease, a figure that rises as obesity and diabetes persist. Risk factors extend beyond age; middle-aged adults remain commonly diagnosed, but lifestyle factors such as sedentary behavior and diets high in processed foods, sugary beverages and unhealthy fats contribute significantly. Genetics may also play a role in susceptibility. Early intervention matters, because reversing liver damage is more likely when the disease is caught early and managed through lifestyle changes.

Early signs of MASH can include upper-right abdominal pain or fullness, persistent fatigue, loss of appetite, swelling in the abdomen, unintended weight changes or yellowing of the skin and eyes. Cleveland Clinic and other medical centers note that while MASH can affect people of any age, it is more commonly identified in adults with obesity or metabolic syndrome. Healthcare providers emphasize that individuals with risk factors should seek evaluation if symptoms arise or if routine tests show abnormal liver enzymes. Lifestyle modification—weight loss through diet and exercise—can halt or reverse disease progression in the early stages, and new therapeutic options are expanding

In a notable line of development, a series of studies have explored the use of GLP-1 receptor agonists—drugs already used to treat type 2 diabetes and support weight loss—for MASH. A major clinical trial involving about 800 participants investigated once-weekly semaglutide and found it effective in reducing liver fat and improving inflammatory and fibrotic markers in fatty liver disease, including MASH. The research team, led by Arun Sanyal, M.D., director of the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, reported meaningful improvements in several liver-health metrics and highlighted the potential for a pharmacologic option beyond lifestyle changes alone. The trial’s results come as the U.S. Food and Drug Administration has approved GLP-1 medications for MASH, signaling a shift in how clinicians may manage this condition in conjunction with diet, physical activity and weight management.

The FDA’s approval of GLP-1 therapies for MASH marks a significant step in expanding treatment options for a disease that has historically lacked approved pharmacologic solutions. By reducing liver fat, mitigating inflammation and potentially slowing fibrosis, these medications offer an additional tool for patients at risk of progression to cirrhosis. Medical experts caution that these drugs are not a universal remedy and emphasize careful patient selection, monitoring for side effects, and integration with lifestyle interventions.

Public-health experts also note Marino’s disclosure as part of a broader health narrative. As obesity and metabolic syndrome become more prevalent, clinicians stress the importance of screening for liver disease in at-risk populations and encouraging routine, preventive care. The condition’s silent nature underscores why primary care providers may screen for liver health during annual checkups or in patients with risk factors, rather than waiting for symptoms to appear.

For individuals concerned about MASH, experts advise starting with a conversation with a healthcare provider, especially if there is obesity, type 2 diabetes, high cholesterol or high blood pressure in one’s medical history. A diagnosis typically begins with a noninvasive assessment of liver fat and inflammation, followed by a discussion of treatment options that may include lifestyle modification and, when appropriate, GLP-1–based therapies. Early detection and sustained management offer the best chance to prevent progression and preserve liver function.

As Marino and other patients navigate this diagnosis, the medical community continues to study and refine approaches to MASH. The combination of lifestyle strategies, advanced imaging and emerging pharmacotherapies may collectively shift the outlook for many people living with this condition, turning a once-hidden risk into a manageable health issue with proactive care.