Editorial: The Metabolic (Dysfunction) Associated Fatty Liver Disease (MAFLD)-Non-Alcoholic Fatty Liver Disease (NAFLD) Debate: A Forced Consensus and The Risk of a World Divide

During the past two years, the redefinition of non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) have been endorsed by international societies of hepatology, patient advocacy associations, and stakeholders. More recently, the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) have attempted to achieve a consensus. Three main fundamental issues raise concerns regarding the validity of the current consensus process. First, the development of the process and the selection of experts in the consensus panels remain unclear. Second, there is a concern regarding the quantity and quality of the evidence considered by the consensus panels. Third, there has been a lack of input to the consensus panel decisions from the academic and clinical community. This Editorial aims to raise an urgent note of caution regarding the consensus process used by the AASLD and EASL regarding fatty liver disease, to prevent world divide and different global definitions and guidelines from being adopted.