Nearly 4 out of 10 Indians may have fatty liver disease, and that is a concerning figure that highlights a growing health crisis. In recent cohort studies, researchers screened nearly 8,000 Indian adults and found that around 40% had fatty liver disease, raising important concerns about the increasing burden of liver-related metabolic health problems in India.
Medically, what was traditionally known as NAFLD (Non-Alcoholic Fatty Liver Disease) is now increasingly referred to as MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). The change in terminology reflects a better understanding of how metabolic factors such as excess body weight, insulin resistance, high blood sugar, and abnormal cholesterol levels can contribute to fat accumulation in the liver.
What Is Fatty Liver?
Fatty liver, also known as hepatic steatosis, occurs when too much fat accumulates inside liver cells. It is commonly linked with factors such as excess body weight, insulin resistance, high blood sugar, high cholesterol, and physical inactivity.
Fatty liver can broadly be associated with metabolic health factors or alcohol consumption. Many people may not experience noticeable symptoms in the early stages, which is why it can sometimes go undetected for years.
Why Is Fatty Liver Becoming So Common in India?
Fatty liver is no longer a condition we associate only with alcohol or older adults. It is becoming increasingly common among Indians, including people who may look perfectly healthy from the outside.
So, why is this happening?
1. Our eating habits have changed.
Indian diets have changed significantly, especially in cities. Processed foods, sugary drinks, refined carbohydrates, fast food, and frequent snacking have become part of everyday life for many people.
When the body regularly receives more calories, sugar, and unhealthy fats than it needs, the liver can start storing the excess as fat inside the liver cells. Over time, this can lead to fatty liver.
2. We are moving less.
Long working hours and desk jobs mean many people spend most of their day sitting. With long commutes, screen time, and little physical activity, daily movement can become surprisingly low.
Regular exercise can help reduce liver fat, even without significant weight loss. Around 150 minutes of moderate physical activity a week is a good target for most adults.
3. Obesity and diabetes are increasing.
Fatty liver is closely linked with metabolic conditions such as obesity, insulin resistance, and type 2 diabetes. As these conditions become more common, so does fatty liver.
You don’t have to be a heavier person to have fatty liver. South Asians can develop metabolic problems at lower body weights compared with some other populations. Someone with a normal BMI can still have significant liver fat, which is why fatty liver can sometimes go unnoticed.
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How Do You Know If You Have Fatty Liver?
Most people don’t have obvious symptoms. You could have fatty liver and feel completely normal.
Some people may experience tiredness or a feeling of heaviness or discomfort in the upper-right side of the abdomen, but these symptoms are not specific to fatty liver. The best way to know is through appropriate testing.
Ultrasound is commonly used to detect fat accumulation in the liver. In some cases, your doctor may recommend a FibroScan, which can assess liver stiffness and help identify whether fibrosis may be present.
If you have diabetes, obesity, high cholesterol, metabolic syndrome, or other metabolic risk factors, it is worth discussing liver screening with your doctor. And even if your weight is normal, don’t assume your liver is automatically healthy.
Can Fatty Liver Be Reversed?
In many people, especially when it is detected early, fatty liver can improve significantly with lifestyle changes.
The most important step is usually weight management. Even losing around 5% of body weight can reduce liver fat, while greater weight loss may help reduce liver inflammation and, in some cases, improve early fibrosis.
Exercise is equally important. A combination of aerobic activity, such as brisk walking or cycling, and strength training can help reduce liver fat and improve insulin sensitivity.
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