New Liver Disease Cases Double as Obesity, Alcohol Collide

A newly defined liver disease linked to alcohol consumption and obesity is surging, drawing significant concern among health experts and federal officials as common risk factors increasingly collide.

The condition, known as metabolic dysfunction and alcohol-associated liver disease, or MetALD, has more than doubled in prevalence since 1990, according to recent research published in JAMA. A separate study this year found that 1 in 10 U.S. adults reported both heavy drinking and a body mass index of 30 or higher in 2023-key risk factors for the disease.

Deaths linked to the condition have also risen sharply over the past two decades, with researchers warning rates could continue to climb without greater awareness and treatment.

An Emerging Liver Disease

MetALD is a term used to describe patients with at least one metabolic risk factor, such as obesity, type 2 diabetes or hypertension, alongside moderate alcohol consumption.

Dr. Samuel Klein, director of the Center for Human Nutrition at the Washington University School of Medicine in Saint Louis, Missouri, told Newsweek that this means alcohol consumption and obesity are “important causes of metabolic liver disease, which includes increased liver fat content, inflammation and fibrosis." Fibrosis is a buildup of scar tissue on the liver that can lead to serious damage.

He explained this is because the adverse effects of alcohol in causing liver fibrosis are “exacerbated in people with obesity who have fatty liver and obesity-related cardiometabolic diseases, including high blood glucose and diabetes, high blood pressure, and abnormal blood lipids,” adding that “even small amounts of alcohol consumption increase the risk of liver fibrosis.”

A Department of Health and Human Services (HHS) spokesperson told Newsweek the department was “concerned about rising rates of chronic disease in the U.S., including liver disease associated with alcohol use and poor metabolic health,” adding that federal guidance “make[s] clear” that drinking less alcohol is better for overall health and that some individuals should avoid it entirely.

Why Are Rates Increasing?

America’s alcohol consumption has been relatively level since 2006, with only a slight increase over the past 20 years, according to data from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Obesity rates, though, have increased notably since 2008, peaking in 2022, according to Gallup data.

Klein 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.”

This is because these conditions “predispose an individual” to develop MetALD at a moderate level of alcohol consumption, Dr. Ashwani Singal, chair of the American Gastro Association Council and the CLD Foundation Alcohol-Associated Liver Disease Committee, told Newsweek.

“The higher the number of metabolic risk factors, the more likely and worse the liver disease," he added.

Klein said that people with obesity, fatty liver or obesity-related cardiometabolic diseases therefore “should not drink any alcohol at all or at least drink four or fewer standard drinks per week.”

He added the risk of liver fibrosis “increases progressively with increased alcohol intake in people who consume five more drinks per week.”

Moderate alcohol consumption–part of the diagnostic criteria for MetALD–is 140 to 350 grams per week of alcohol for women (which is roughly 10 or more drinks a week) or 210 to 420 grams per week for men (about 15 or more drinks).

Experts Find The Data ‘Concerning’

Singal said he found the surge in MetALD cases in the country “concerning” for several reasons, since MetALD results in an individual facing higher risks of permanent damage to the liver and other complications, as well as the fact there is a “lack of approved liver targeted therapies” for the condition.

He also said there’s a “lack of adequate training and time for gastroenterologists and hepatologists to address and manage alcohol use disorder (AUD) in patients with liver disease.”

Dr. Rohit Loomba, director of the MASLD Research Center at the University of California at San Diego, told Newsweek he was “concerned” about the rise in cases, noting that alcohol-related liver disease is now a leading indication for liver transplant in the U.S. and a “preventable cause for cirrhosis." Cirrhosis is advanced scarring of the liver.

A 2025 study also found that worldwide, steatotic liver disease (SLD), which includes ALD, MetALD, and MASLD, is now the leading cause of liver transplantation.

He also said another concern is most people with diabetes are “unaware that they are at significantly higher risk” of developing the condition, and that it is more prevalent among those of Hispanic ethnicity.

Loomba said 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 for the disease.

Singal also said “we need to focus on controlling the risk factor of alcohol use,” adding that hepatology (the medical specialty focused on the liver) training programs need to integrate education on alcohol use disorders to better equip specialists to manage these patients.

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This story was originally published June 20, 2026 at 4:30 AM.