This is something I’ve rarely talked about. I can’t quite believe I’m sharing it here — but after today, I realise it’s time.
I’ve mentioned my liver condition a handful of times over the years, but reading a recent article in the Daily Mail about NAFLD (non-alcoholic fatty liver disease) shook me to my core. It was the wake-up call I didn’t know I needed — and maybe, if you’re reading this, yours too.
My Family History and a Painful Truth
To understand the full weight of this, I need to talk briefly about my mum. Her story isn’t mine to tell, but this bit matters: my mum died at 51 from cirrhosis of the liver — sudden, devastating, and still a mystery that haunts me.
Several years ago, routine blood tests flagged elevated ALT levels — an enzyme that rises when there’s liver damage. ALT, or alanine transaminase, is one of the earliest blood indicators of liver injury, often before symptoms appear. My GP was so alarmed he sent me immediately to A&E at Aintree — and eventually for an agonising liver biopsy.
The result? Non-alcoholic steatohepatitis (NASH) — inflammation and fat in the liver not related to alcohol. I don’t drink and it’s been many years since I have, but I’ve carried extra weight around my middle for years — exactly the kind of visceral fat linked to disease progression.
The Genetic Link and Growing Fears
Doctors believe my mum may have had a faulty enzyme, a genetic predisposition I may have inherited too. Despite attempts, I haven’t been able to see my consultant for years — my health issues, especially ME/CFS and endometriosis, make regular appointments almost impossible. Yet I know how close I am to the same age my mum was when she passed — and it terrifies me.
What the Daily Mail Didn’t Tell — But Local Research Did
I then discovered a Liverpool‑based lifestyle intervention study by LJMU and Royal Liverpool Hospital. They evaluated a 12-week programme offering direct‑access lifestyle coaching to NAFLD patients. Of 167 people offered support, just 16 (fewer than 1 in 10) completed it. And yet:
Those who did had significant weight loss (~2.3% body weight, BMI drop of 0.76 kg/m²)jenndowd.substack.com+1en.wikipedia.org+1.
Many showed improved ALT scores and reported better emotional wellbeing .
But uptake was low, underscoring how difficult “lifestyle change” can feel when you’re unwell .
Knowing this was happening here in Liverpool — people just like me — hit hard. I saw my own struggles in it.
New Hope: Ozempic (Semaglutide) as a Potential Treatment
While diet and activity remain the cornerstone of managing NAFLD/NASH, exciting developments are emerging in drug therapy:
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Semaglutide — better known by brand names Ozempic (diabetes) and Wegovy (weight loss) — has shown dramatic benefits in trials for MASH (metabolic dysfunction-associated steatohepatitis):
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A 72‑week phase III trial with 800 patients showed 62.9% saw reduced liver fat and inflammation, vs 34.3% on placebo — and 36.8% saw improvements in fibrosisnejm.org+15health.com+15pubmed.ncbi.nlm.nih.gov+15.
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A systematic review found semaglutide significantly improves liver enzymes, fat reduction, fibrosis, and BMI in NAFLD patients timesofindia.indiatimes.com+15mdpi.com+15pmc.ncbi.nlm.nih.gov+15.
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Even at 24 weeks, semaglutide improved liver enzymes and metabolic markers — though mild gastrointestinal side effects were noted pubmed.ncbi.nlm.nih.gov.
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That means a medication already on the NHS for diabetes and weight could soon be prescribed to help reverse liver disease — not just manage blood sugar.
Why This Matters for Me (and You)
Local evidence shows structured support works — but uptake is low.
Emerging drug options offer new hope for those struggling with lifestyle change.
Research from Liverpool offers both credibility and relevance to people like me
What I’m Doing Right Now
Drinking more water
Overhauling our diet — visiting our favourite butcher to prioritise lean meat, fresh veg, whole grains, and ditch sugar-heavy ultra-processed foods.
Talking to my GP about semaglutide eligibility — especially given my BMI and NASH history.
Exploring local lifestyle support programmes — even though uptake may be low, I’m ready to rebuild support gradually.
If You’re Reading This…
Notice pain or discomfort under the right ribs after eating? Even without alcohol use — mention it to your GP.
Elevations in liver enzymes? Ask about FibroScan, ELF blood test, and now semaglutide eligibility.
Don’t underestimate the power of local support or emerging treatments and reach out to all of them!
Let’s Take Our Health Seriously, Even When It’s Hard
Being bedbound, unwell, or overwhelmed doesn’t mean you can’t take steps for your health. Embrace the love you deserve. Use the tools — local or new medications — that are now more accessible than ever.
Together, let’s stop being ashamed of the things we can’t control — and start embracing the ones we absolutely can.
With love,
Alisha x
📚 Research and Resources Behind This Post
Every story I share is rooted in lived experience, but also guided by real data, local research, and evidence-based care. Below are the key sources that supported this post — for anyone who wants to dig deeper or start their own journey of understanding.
📰 Articles & Features
Daily Mail (2023)
Are you among the one in five adults who have potentially fatal fatty liver disease?
[Summary included in post. Original article appeared in the Mail on Sunday Health Section.]🧪 Medical & Clinical Research
Patanwala et al., 2020 – Liverpool John Moores University & Royal Liverpool Hospital
Direct access lifestyle training improves liver biochemistry and causes weight loss but uptake is suboptimal in patients with non-alcoholic fatty liver disease (NAFLD).
📍 This study was based here in the North West and is essential reading for anyone managing NAFLD or NASH.
🔗 Read full study on LJMU Research OnlineMedlinePlus – ALT Blood Test
Helpful overview of ALT testing, how it works, and why it matters for early liver diagnosis.
🔗 https://medlineplus.gov/lab-tests/alt-blood-test/NICE Guidelines / BMJ on NAFLD (UK)
Referenced throughout the blog post — supporting the use of tools like FibroScan and ELF blood tests for early detection.NEJM & Clinical Trials on Semaglutide (Ozempic / Wegovy)
Referenced data from Phase III clinical trials showing the role of semaglutide in reducing liver inflammation, fat accumulation, and fibrosis in patients with MASH (a progression of NASH).
📍 Based on global research, with potential UK relevance pending NHS guidance updates.
💬 Final Note
I’m not a doctor — but I am someone who lives with this, just like many of you. I believe the best advocacy is a mix of heart and hard facts. If you ever feel lost, overwhelmed, or unsure where to begin, start with compassion — for yourself, and for the journey ahead and if you ever need to talk I’m here ❤️
Love Always
Alisha ❤️
Frequently Asked Questions About NASH (Non-Alcoholic Steatohepatitis)
What are the early signs of NASH?
NASH is a more advanced form of non-alcoholic fatty liver disease (NAFLD). It causes inflammation and damage in the liver due to a buildup of fat. If left untreated, it can lead to scarring (cirrhosis), liver failure, or liver cancer.
Can you get liver disease even if you don’t drink alcohol?
Yes — both NASH and NAFLD are liver diseases not caused by alcohol. They are often linked to weight gain, insulin resistance, and diet. Many people diagnosed drink little or no alcohol at all.
What are the early signs of NASH or NAFLD?
Most people experience no symptoms in the early stages. Some might feel tired or have pain near the liver. It’s often discovered during routine bloodwork or imaging like a FibroScan.
Can NASH be reversed?
Yes — especially in early stages. Lifestyle changes such as reducing sugar, eating a Mediterranean-style diet, exercising, and losing weight can reduce liver inflammation and fat buildup.
What treatments are available for NASH in the UK?
At the moment, the main treatment is lifestyle change. However, some medications like semaglutide (Ozempic) are showing promising results in clinical trials. Early diagnosis remains key, often via FibroScan or ELF blood tests.
