Most people with fatty liver don’t feel sick, and their liver blood tests are often normal—so doctors can’t rely on symptoms or routine blood work to find it; they need imaging or to check for obesity and diabetes instead.

This study says that people who are obese and have fatty liver often don’t feel sick, and their blood tests don’t always show problems — so doctors have to look at their weight, metabolism, and use scans instead of just symptoms or blood work.