The Fatty Liver Assessment in Germany (FLAG) cohort study identifies large heterogeneity in NAFLD care

•This is the first report on NAFLD from a secondary-care real-world cohort in Germany.•In this outpatient cohort, diagnostics rely heavily on non-invasive surrogate scores and elastography to stage NAFLD.•Every 10th patient presents with advanced fibrosis at baseline.•Management of NAFLD in Germany consists predominantly of general lifestyle recommendations and best supportive care.•The study underlines the applicability of non-invasive tests to identify patients at risk of advanced fibrosis in secondary care in Germany.