NFL Legend Dan Marino Talks About His MASH, Liver Disease Diagnosis

NEW YORK, NEW YORK – JUNE 21: Dan Marino speaks onstage at Fanatics Fest NYC 2025 at Javits Center on June 21, 2025 in New York City. (Photo by Slaven Vlasic/Getty Images)

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To say that Dan Marino has had an unordinary career would be an understatement. The Pro Football Hall of Famer who played 17 years for the Miami Dolphins is widely considered to be one of the greatest quarterbacks of all time, served as an analyst for The NFL Today on CBS for over a decade and most importantly was in a movie with Jim Carrey and an actual dolphin. He’s also just revealed that since 2007 he’s had a liver disease diagnosis called MASH that may initially seem unordinary. But it’s a lot more ordinary and common a condition than you might think, affecting as Marino stated, “around one in 20 people.”

That’s why Marino would like more people to be aware of MASH and get checked for it. So, it shouldn’t seem too out of the ordinary for Marino to be part of Novo Nordisk’s new “Unordinary Stories” campaign. This campaign has different athletes like Marino and basketball Hall of Famer Sheryl Swoopes sharing their health journeys. And Marino recently met with me to go through his.

The Only Symptom Marino Had Was Fatigue

Marino detailed what happened after he had retired from playing pro football in 2000: “I got a little overweight and I wasn’t working out like I should have right after I retired.” The pounding of his lengthy NFL career didn’t exactly help him keep off the pounds. “My knees were pretty bad, you know, so I kind of couldn’t do that much,” Marino explained. “Then I had knee replacements.” He added that his diet wasn’t exactly exemplary at the time either: “I just ate whatever I wanted to.”

Then in 2007 he noticed that he was suffering from some fatigue. Not sacked-by-Bruce-Smith type of fatigue but enough fatigue for Marino to mention it to his doctor during his yearly physical. Standard blood tests then revealed his liver function to be out of sorts. The doctor then recommended further testing that eventually led to a diagnosis of MASH.

MASH Is The Accumulation Of Fat In The Liver

Now, MASH may sound like something you would do with potatoes or monsters or the name of a TV series that ran from 1972 to 1983. But in this case it stands for metabolic dysfunction-associated steatohepatitis. While this may sound like, oh, a mash of difficult-to-understand words, breaking down each of the words can help understand what this condition is all about.

“Hepat” is medicalese for liver, and “itis” after any body part means inflammation of that body part. So, “hepatitis” would be inflammation of the liver. “Steato” is medicalish for fat. So, steatohepatitis is the build-up of fat in the liver, leading to inflammation of that organ.

“Metabolic dysfunction” means something’s gone wrong with your metabolism, and “associated” means, well, associated. Thus, in MASH, the accumulation of fat is associated with metabolic dysfunction and not something like consuming too much alcohol. That’s why MASH used to be called “non-alcoholic fatty liver disease,” which essentially saying what it is not caused by rather than what it is, hence the name change.

Risk factors for developing MASH consist of things that may either disrupt your metabolism or signs that your metabolism has been disrupted. These include having high cholesterol or high triglycerides levels in your blood or high blood pressure. Having your body be in the overweight or obesity ranges can mean you are at risk too. So can insulin resistance or full-blown type 2 diabetes.

What Are The Signs And Symptoms Of MASH

If Marino hadn’t gotten regular check-ups with his doctor, who knows when he might have realized that something was amiss with his liver. “It can go unnoticed,” Marino warned. “You may never get treated for it or you may never do the things you need to do to control and manage it.” That’s because your liver won’t give you obvious clues that say there’s a MASH up going there. Besides fatigue, the other possible symptoms can be quite vague and non-specific like abdominal discomfort, pain or swelling or unexplained weight loss, muscle loss or muscle weakness. Unexplained swelling in your legs is a possibility too.

Only when MASH gets more advanced might your liver deliver clearer signs. Jaundice may result due to bilirubin building up in your body because your liver can’t keep up with processing it. This could turn your eyes and skin rather yellowish.

Alternatively, you may notice nothing, nada, zilch and have no symptoms, especially early on in the course of MASH. This can leave you with a “fat” chance of detecting MASH unless you happen to have your liver function tests checked, which are typically among the blood tests checked as part of an annual physical.

Abnormal liver function tests, otherwise known as LFTs, can prompt your doctor to check your liver more carefully. The next step can be ordering imaging of your liver like an ultrasound or CT to look for evidence of abnormalities like fat accumulation in your liver. The most definitive way of diagnosing MASH is via a liver biopsy. But getting a needle stuck into your liver is not the funnest of things so wouldn’t been done without higher suspicion already.

All of this is why Marino urged, “Get to your doctor, get your physicals.”

MASH When Untreated Can Lead To Serious Complications

If you are wondering what’s the worst thing that can happen if you were to miss diagnosing or treating MASH, it’s pretty darn bad. This isn’t a fatty liver and let live situation. The accumulation of fat and resulting inflammation could lead to more permanent damage over time, such as scarring of your liver, known as liver fibrosis. When such fibrosis becomes extensive enough, you can develop cirrhosis. This is when your liver is so scarred up that there’s barely enough normal tissue to perform the routine functions of the liver. At some point, such cirrhosis could lead to liver failure, where your liver just can’t do it’s liver things anymore, which is bad, life-threateningly bad.

That’s because even though you may not routinely think about your liver or see it on selfies, it plays a bunch of vital roles for your body. This includes serving as a sewage station for your body—filtering and detoxing your blood, breaking down old red blood cells and recycling their iron—and a manufacturing plant of sorts—making key proteins and immune system cells, storing vitamins and minerals and processing your nutrients. Your liver also plays the very sweet role of regulating your blood sugar levels by releasing glucose and storing glycogen when appropriate. Then there’s the rather bile function of producing bile that can help with the breakdown and absorption of fats during digestion.

Liver failure isn’t the only thing to worry about when it comes to MASH. MASH can lead to hepatocellular carcinoma, a form of liver cancer, as well. You could take MASH to heart, so to speak. MASH increases your risk of different heart conditions like a heart attack and stroke. These are all easily life-threatening conditions.

Marino Made Changes In His Diet And Physical Activity To Manage MASH

Fortunately, as Marino emphasized, “[MASH] can be manageable. That’s why you should have a positive attitude about it and just understand what the circumstances are.” Lifestyles changes such as eating better, being more physically active and abstaining from alcohol may halt or even reverse the progression of MASH.

“I try to eat the Mediterranean diet, I try to stay on that as much as possible,” Marino said. “My wife kind of likes that food, too. That was actually the suggestion of the doctor’s too, get on and that kind of diet as much as you can.”

Marino talked about his exercise program as well. “I walk a lot,” Marino mentioned. “I try to get on a treadmill, walk, ride a bike and try to lift a little bit. I don’t lift as much nearly as I probably should. I should lift a little more, but those are the things.”

He added, “Your body sometimes doesn’t always let you do all those things, so you got to find what’s best for you. But you do still need to get up and move, exercise, and then eat the right things.”

As mentioned previously, being in overweight or obesity ranges are risk factors for MASH. So, an important part of MASH management is managing your weight. If lifestyle changes aren’t enough, your doctor may consider things like glucagon-like peptide-1 agonists such as Ozempic, Wegovy, Mounjaro or Zepbound. I’ve already written about GLP-1 agonists quite extensively in Forbes, such as how they can help manage obesity and diabetes and the growing demand for them in general. These medications have the added benefit of reducing the amount of inflammation and fat in your liver.

Depending on that state of your MASH and body, your doctor may suggest other things as well. This can include various supplements such as vitamin E, medications to manage diabetes if you have it and a medication, Resmetiron, which goes by the brand name Rezdiffra, that can help slow down or reverse scarring of your liver from MASH.

Marino Urges The Importance Of Optimism

Another thing that can help is a dose of optimism. “That’s the most important thing. It can be manageable,” Marino urged. “That’s why you should have a positive attitude about it and just understand what the circumstances are.” Marino described how his football career has helped him deal with his diagnosis: “I’ve had knee operations, I had an Achilles injury, I had new knees put in, a lot of things, and it’s really trying to figure out what’s best for you and what makes you go forward in life in a positive way.”

Regarding how his MASH is being managed, he did say, “You know, our bodies change a little [over tine], but I try to be as consistent as I can with all the things that I’m doing and so far, I’ve I’ve been doing well.”

He added that everyone’s different and you have to figure out “what it’s going to take to make sure that you can be with your friends, you can be with your family, you can be with your grandkids, your kids. That’s the thing I learned through playing football, you got to move forward, you got to do the things you need to do to be the best you can be at the top of your game.”

The player known as Dan the Man during his playing days remains very active in a lot of different arenas. He clearly has more than a passing interest in the NFL, so to speak. He continues to work with the Dolphins and feels that “the NFL is in a great spot right now, continuing to grow.” He’s also been working with other organizations outside the NFL, including doing different investment things. He also talked about being a “grandfather and trying to take care of my family.” MASH may have blind-sided him momentarily when he was first diagnosed. But like Dan Marino did oh-so-many times during his football career, he evaded that initial rush and has kept going with his decidedly unordinary life.