Life is good, fat becomes popular, obesity brings a very troublesome problem is gradually affect our health, non-alcoholic fatty liver disease (NAFLD) is such a disease is affected, this disease in the end how much trouble but not really known for the road! Currently, about 1 billion people worldwide are overweight or obese, and its active state, namely non-alcoholic steatohepatitis (NASH), is characterized by hepatocellular damage, liver inflammation, and progressive fibrosis, and has become the most important cause of liver failure and hepatocellular carcinoma. The proportion of patients with NASH ranges from 15% to 55%; among them the proportion of patients with NASH ranges from 20% to 80%. However, hepatologists see only the majority of patients with severe disease, which represents only the tip of the iceberg, and there is a lack of awareness of this disease worldwide. Therefore, there are many unresolved issues in screening, initial evaluation, non-invasive screening, liver puncture biopsy, management, and follow-up of fatty liver. An important report “Solving the UK’s liver disease crisis: a blueprint for reducing premature deaths due to alcohol abuse, obesity, and moving towards excellence in liver disease healthcare” was published in The Lancet in 2014. The statistics are staggering. The health status and life expectancy of patients with chronic diseases such as stroke, heart disease and many types of cancer have improved significantly over the past 30 years, with the sole exception of liver disease. Mortality from liver disease has increased by 400% since 1970 (Figure A), and the number of NAFLD liver transplants has reached nearly 150 (Figure B), a number that, if converted to our population base, is close to the number of liver transplants for hepatitis B in this country. We generally pay more attention to chronic liver injury diseases like hepatitis B and C, knowing that they can cause serious consequences such as cirrhosis and liver cancer, not knowing that the result of any chronic liver injury to the liver is the same, regardless of the virus and fat. It’s just that you don’t feel this process. The latest research has confirmed that NAFLD can cross the stage of cirrhosis and develop directly into hepatocellular carcinoma. The author’s old family has a lot of blood donors infected with hepatitis C due to historical reasons. At the beginning of my medical career, I repeatedly advised these people in my hometown that hepatitis C must be treated and that the consequences were serious, but they were not convinced, and 30 years later, 30% of those infected people have become cirrhotic liver cancer. Today I advise those NAFLD, the disbelief now will pay the price in the future! You are already a patient, please refer to the advice I give you! (Figure C)