MetALD Prevalence More Than Doubles Since 1990 While U.S. Alcohol Use Stays Flat

Including liver disease associated with alcohol use and poor metabolic health. Federal guidance makes clear that drinking less alcohol is better for overall health and that some individuals should avoid it entirely, the spokesperson said. Dr.

Ashwani Singal, chair of the American Gastro Association Council and the CLD Foundation Alcohol-Associated Liver Disease Committee, said the increased prevalence of obesity and obesity-related cardiometabolic diseases is likely responsible for the increase observed in metabolic liver disease without an increase in alcohol consumption.

The higher the number of metabolic risk factors, the more likely and worse the liver disease, he said. Singal said he found the surge in MetALD cases concerning because of higher risks of permanent liver damage, a lack of approved liver-targeted therapies, and a lack of adequate training for gastroenterologists and hepatologists to manage alcohol use disorder.

He said hepatology training programs need to integrate education on alcohol use disorders. Dr. Rohit Loomba, director of the MASLD Research Center at the University of California at San Diego, said he was concerned about the rise in cases.

U.S. and a preventable cause for cirrhosis, he said. A 2025 study found that worldwide, steatotic liver disease, which includes ALD, MetALD and MASLD, is now the leading cause of liver transplantation.

Loomba said most people with diabetes are unaware that they are at higher risk of developing MetALD and that the condition is more prevalent among those of Hispanic ethnicity. While MetALD is a rare condition, it has a high risk of mortality, and more needs to be done about raising awareness and improving screening, he said.

Singal said the focus should be on controlling the risk factor of alcohol use.