LIFESTYLE NEWS - Feeling constantly tired, struggling to lose weight or noticing your fitness decline may seem like normal signs of a busy lifestyle. However, doctors warn these subtle changes could point to an underlying metabolic problem that places your liver and overall health at risk.
According to Dr Gerhard Vosloo, founder and head consulting practitioner of Dr GL Vosloo Medical Practice, managed by BioWell, these symptoms may be linked to metabolic dysfunction-associated steatotic liver disease (MASLD) – now recognised as the most common chronic liver disease in the world.
Unlike liver diseases caused by viral infections or excessive alcohol consumption, MASLD is closely linked to metabolic health and often develops silently over many years.
The condition is associated with risk factors that can usually be identified through routine health checks, including blood sugar, cholesterol, blood pressure, body weight and liver function.
World Hepatitis Day highlights broader liver health
Observed annually on 28 July, World Hepatitis Day traditionally raises awareness of viral hepatitis, particularly hepatitis B and hepatitis C.
Dr Vosloo believes the occasion should also encourage conversations about metabolic health and MASLD, which is increasingly affecting people worldwide.
"Metabolic health is about far more than body weight because the same underlying problems that make it harder for the body to manage blood sugar, fat and energy can quietly place the liver and overall health at risk," says Dr Vosloo.
"This month, we should go further than raising awareness of hepatitis by encouraging people to speak to their doctor about the metabolic markers they cannot see or feel."
How metabolic dysfunction affects the liver
The liver plays a vital role in regulating how the body stores and uses energy.
"Every time you eat, your liver helps determine what should be stored, used for energy or sent elsewhere in the body," explains Dr Vosloo.
"If the body becomes less responsive to insulin, that system starts falling out of balance. More sugar is converted into fat, more fat reaches the liver and some of it begins to build up inside liver cells."
Most people experience no obvious symptoms during the early stages of MASLD.
However, as fat accumulates in the liver, it can progress to inflammation and, in more severe cases, permanent scarring that affects liver function.
Dr Vosloo says many people mistakenly think fatty liver disease is only a liver problem.
"Although the liver is where the condition becomes visible, the real issue is the underlying metabolic dysfunction. We need to understand and manage the patient as a whole rather than treating the liver as an isolated organ."
Routine health checks can identify risk
A proper medical assessment remains the best way to identify metabolic dysfunction before serious complications develop.
Doctors may evaluate a patient's personal and family medical history, medication use, body weight, waist circumference and blood pressure, while also assessing blood glucose, HbA1c, cholesterol, triglycerides and liver enzyme levels.
Depending on the results, further investigations may be recommended to detect fat accumulation in the liver or identify early signs of liver scarring.
Lifestyle changes remain the foundation of treatment
Through the BioWell platform, patients can access a structured online metabolic management programme that begins with a consultation with one of the practice's doctors, followed by ongoing monitoring and personalised care.
"We assess each patient's full clinical picture, request relevant blood tests where necessary and develop an individual treatment plan based on the factors affecting their metabolic health," says Dr Vosloo.
Treatment does not automatically begin with medication.
Instead, a personalised plan may focus on improving nutrition, increasing physical activity, achieving healthy weight loss, improving sleep and addressing other lifestyle factors that influence how the body processes sugar, fat and energy.
Where clinically appropriate, doctors may also prescribe GLP-1 receptor agonists, which can help regulate appetite, improve blood sugar control and support weight loss. By reducing some of the metabolic strain on the body, these medicines may also help lower the risk associated with MASLD.
However, Dr Vosloo stresses that these medications are not suitable for everyone and should only be prescribed and monitored by a qualified medical practitioner as part of a comprehensive treatment plan.
Long-term monitoring is essential
Whether or not medication forms part of treatment, regular follow-up remains important.
While weight loss is one measure of progress, it does not provide the full picture of metabolic health.
Doctors may continue monitoring blood sugar, cholesterol, triglycerides, blood pressure, liver enzymes and other metabolic markers over time to assess a patient's progress and reduce the risk of long-term liver disease.
Dr Vosloo says early intervention remains one of the most effective ways to protect liver health.
"Understanding your metabolic health before symptoms become severe allows doctors to identify risk factors early, provide appropriate treatment and help prevent long-term damage to the liver and overall health."
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