Sadly that story happens all the time. It is mostly the result of the fact that they have no treatment that the average doc doesn’t pursue fatty liver very far. Their education is primarily about how to deal with symptoms once liver failure begins but they have little but diet and exercise advice to offer along the way. Even the gastro docs tend not to engage until you get sick.
At the heart of it is the fact that we have had no tests other than biopsy that gave you actionable information and many people never have any symptoms until they become ill. As patients we tend not to respond effectively to the advice to lose weight. The liver function blood tests they do often don’t even start to register before a substantial amount of damage is done. Countless people arrive at end stage liver disease without ever having had a symptom of any kind because the liver is so robust and fatty liver is usually thought to not be very dangerous.
When you put those facts on top of the epidemic of obesity, one of the primary drivers of fatty liver leading to disease, you can see why a medical problem that 50 years ago was quite rare is a tidal wave of illness now working its way through our society. The fact that the new technologies are coming of age is incredibly important from a health perspective but also foreshadow the fact that vast amounts of money will be spent fighting liver disease as large numbers of people become ill.