Reversing fibrosis in metabolic dysfunction–associated steatohepatitis—beyond telling patients to lose weight

To reverse fibrosis in late-stage metabolic dysfunction-associated steatohepatitis (MASH), guidelines recommend that patients shed at least 10% of their body weight. However, losing this much weight remains a challenge for most patients, especially with lifestyle modifications alone. Moreover, not all patients with MASH are overweight or obese. This review summarizes pharmacologic, surgical, and bariatric endoscopic treatments for MASH to guide primary care physicians and internists.