Often resolves with smaller meals, lower fat intake, and eating slowly
Patients should be counseled to: Maintain adequate hydration based on individual needs (aim for pale yellow urine color, unless on fluid restrictions) Sip fluids throughout the day rather than consuming large volumes at once Consider low- or no-sugar oral rehydration solutions if experiencing persistent vomiting or diarrhea (avoid sugar-sweetened sports drinks if you have diabetes) Monitor for signs of dehydration including dark urine, dizziness, dry mouth, and decreased urination Weight loss-associated fluid shifts occur as adipose tissue is metabolized and glycogen stores are depleted
The visible results of inflammation reduction include reduced facial puffiness, improved skin quality (clearer, more even tone, reduced redness), decreased joint swelling and pain, improved eye appearance (reduced under-eye bags and redness), and a general appearance of vitality that people describe as looking younger and healthier
Two drugs have been approved by the US Food and Drug Administration for MASH with grade 2 or 3 fibrosis: resmetirom (which is suitable for lean patients) and semaglutide
Kidney Int Suppl 114:S12S19
NICE guidance in the UK recommends stopping or switching medications if you have lost less than 5% of your body weight after 6 months of treatment