This serious disease is reversible, but too many Coloradans don’t get the treatment they deserve

As a gastroenterologist, I see hundreds of patients every year who are suffering from a potentially life-threatening disease that most of them have never even heard of before entering my office: metabolic liver disease.

Metabolic-associated steatotic liver disease, or MASLD, which can develop unnoticed over several years, affects more than 40% of Hispanic patients and costs the U.S. health care system more than $100 billion annually. The most frustrating part is that this serious and sometimes lethal illness can be reversed with early identification and treatment.

MASLD is directly linked to obesity and represents an urgent yet overlooked health crisis —especially in Hispanic communities. By the time patients reach me, some are severely ill, and some will die without a liver transplant. Physicians know how to prevent MASLD: by treating obesity. Yet many patients lack access to the treatment and care that could be a lifesaver.

I recently treated a patient with significant fatty liver disease on course to develop liver cirrhosis. She had struggled with her weight for years, and despite her best efforts, she could not make any progress. I worked with her to introduce a lifestyle intervention program that focused on meal replacements and behavior change. She quickly learned that portion control was her biggest challenge, especially when eating out or celebrating holidays. Using what she’s learned from the program, she finally achieved sustainable weight loss and has been able to stop seven prescription medications. Her liver tests are now normal, and she has maintained this progress for four years. She is now a role model for her family and influences them to make healthier choices. Her progress is nothing short of inspiring.

In Colorado, the Hispanic community is the fastest-growing demographic and is diagnosed with obesity at rates higher than the general population. Certain genetic factors also increase the susceptibility of Hispanic patients to MASLD. But unless we address underlying obesity, we will continue to waste billions of dollars and lose countless lives needlessly.

In 2013, the American Medical Association declared obesity a disease due to its complex nature, shaped by genetics, environment and biology. This declaration was also intended to reduce the stigma associated with obesity so that patients would be more likely to seek help. However, the most effective treatments, such as nutritional counseling and new FDA-approved medications, are not covered by Colorado’s Medicaid program, making them inaccessible for those in greatest need.

At a time when Medicaid funding is in jeopardy, Colorado policymakers have an opportunity to reduce the cost of health care by covering less-costly nutritional counseling and behavioral therapy. Investing in coverage of FDA-approved obesity medications has the potential to reduce long-term costs even further, with better health outcomes.

Physicians and policymakers must come together to recognize the connection between obesity and liver disease and develop lasting solutions to ensure patients receive the treatment they deserve. The liver is the body’s natural detox system, and we cannot live without it. However, it can’t protect us if we don’t protect it.