ILLUSTRATED PATIENT GUIDE

Fat, fibrosis and cirrhosis: what is the difference?

Fat in the liver does not automatically mean fibrosis or cirrhosis. Not everyone develops these stages.

1. 1 · Fat accumulation: MASLD

   Fat builds up inside liver cells.

2. 2 · Steatohepatitis: MASH

   Fat accompanies liver-cell injury and inflammation; scars may develop.

3. F0 · No fibrosis

   This staging system describes scarring, not the amount of liver fat.

4. F1–F3 · Fibrosis before cirrhosis

   F1: mild · F2: moderate · F3: advanced bridging fibrosis, before F4.

5. F4 · Cirrhosis

   Extensive scarring alters liver structure and may affect blood flow and function.

Fibrosis can regress when its cause is treated, especially earlier stages. F4 can also improve, but this does not guarantee a normal liver or remove the need for follow-up. Progression is not inevitable; enzymes or stiffness alone cannot establish the stage.