donate now The Fatty Liver Foundation

2023 Findings

2023 marks the second-year run of The State of NAFLD/NASH Care in America™, a pioneering national initiative that aims to make a significant impact within the NAFLD/NASH patient community. This initiative surveys the real-life experiences of adults with NAFLD/NASH across the United States, promoting the ongoing development and implementation of practical solutions to improve diagnosis, treatment, care, and support for those affected by these conditions.



Click the image below for an in-depth review of our survey findings. Compared to 2022, the following changes were observed:


  • Primary care remains a common entry point for NAFLD/NASH patients in their diagnosis experience.
  • Tiredness, abdominal pain and/or swelling, and changes in sleep remained the most common symptoms before diagnosis, though their reported frequencies decreased slightly in 2023.
  • Most respondents were diagnosed with either NAFLD (24.8%) or Stage 4 NASH (21.3%). Some respondents (15.2%) were not aware of their exact disease stage at diagnosis.
  • Among 2023 respondents, slightly more (0.6%) were given more tests to establish a cause of their diagnosis. Less (4.6%) reported they were told there was nothing to worry about.
  • Three out of four (83.0% in 2022 and 83.9% in 2023) respondents felt they were given none or not enough information at diagnosis.
  • A new question in 2023, about one out of ten (9.9%) respondents reported having been denied a referral to a specialist before.
  • A new question in 2023, over nine out of ten (96.4%) said they were not currently enrolled in a clinical trial.
  • About one out of three (35.6% in 2022 and 34.3% in 2023) still did not have someone to turn to if help was needed or wanted.
  • Health (82.0%) was the most frequently reported social insecurity followed by money (51.2%) and food (19.2%).
  • The average rating of medical care since diagnosis improved about 3 points (44 to 47) between 2022 and 2023.
  • Tiredness, body pain, and abdominal bloating remain the most frequently experienced symptoms among respondents at the time of survey.
  • Reported feelings of anxiety, irritability, and fearfulness increased between 2022 and 2023.


Click the images below to learn more about our 2022 findings including who participated in the survey, key findings, what we have learned, and important takeaways.