Keeping secrets from your doctor could hurt your health

Your liver may store excess fat when you’re living with metabolic dysfunction-associated steatohepatitis (MASH), but does it also store secrets you’re keeping from your healthcare team? Mine once did.

I’ll make admissions in this column that I never would have made to my doctors years ago. Did I eat too much fried food? Binge-drink on weekends? Skip exercise entirely? Short of making me walk a metaphorical plank, I was a locked vault. I was afraid of being judged, and worse, afraid that honesty might cost me access to care. I’m still not sure where that idea came from, but it had a long shelf life.

After leaving my very strict upbringing in Utah, I did what many young adults do. I rebelled.

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When I returned home for a family wedding, I packed cigarettes in my purse as a kind of “moral support.” I was bracing for the usual questions: Why aren’t you married? Why no boyfriend? Why move 2,000 miles away? Before I could light one, my mother found them. She was furious.

My first instinct was denial. Those weren’t mine. I was holding them for a friend. Cigarettes were disgusting. I knew firsthand how hard it had been for my parents to quit. Still, I grabbed the pack from her hand and dumped it into a full trash can, a small act of theater designed to keep me from retrieving them later. My mother looked relieved, but she wasn’t fooled.

Doctors, I’ve learned, are not so different from mothers. They see more than we think. And unlike my younger self, I now understand that hiding things from them only hurts me.

Your doctors are not the enemy

As I continue managing a complex condition like MASH, honesty with my healthcare team isn’t optional. It’s foundational. According to the National Institute of Diabetes and Digestive and Kidney Diseases, lifestyle factors such as diet, alcohol use, and physical activity play a major role in both the progression and potential improvement of fatty liver disease. Translation: What you don’t say can absolutely shape your outcome.

I quit smoking about a year after that trip home. Thankfully, it never became a full addiction. It was more of a stress habit, one I eventually replaced with something healthier: writing. Getting my thoughts onto paper turned out to be far more effective than letting them simmer into something more dangerous. It was also a lesson. If you feel the need to hide a habit from people who care about you, it’s worth asking whether that habit is serving you at all.

It’s important to understand that your doctor is not your priest, and the exam room is not a confessional. But it is a place where truth matters. Medical professionals are trained to treat, not judge. And when they express concern or even disappointment, it’s rarely about control. It’s about outcomes.

These days, I try to live as an open book. I own my past, but I also make deliberate choices not to repeat it. My health, especially my liver health, sits at the top of that priority list.

Organizations like the Global Liver Institute emphasize that early intervention and transparency with your care team can significantly improve outcomes for people living with liver disease. They understand the sacred relationship between doctors and patients and encourage collaboration to support healthy outcomes. That means the uncomfortable conversations are often the most important ones.

The next time you see your gastroenterologist or hepatologist, remember this: They are not the enemy. They are your best ally in a fight that requires strategy, not secrecy.

Unlike Wonder Woman, they don’t have a Lasso of Truth.

So bring your own.

And aim it at the real enemy: MASH.

Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.