India is facing a rapidly growing liver health crisis, with fatty liver disease emerging as one of the country's most widespread yet under-recognized health conditions. Once considered a problem largely linked to excessive alcohol consumption, fatty liver disease is now increasingly driven by metabolic disorders such as obesity, diabetes, hypertension, and sedentary lifestyles, affecting millions of Indians across age groups.
A Silent Epidemic: 120 Million and Counting
The condition, now classified as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), is estimated to affect between 16% and 32% of India's population, equivalent to nearly 120 million people. The findings, based on a review of recent national and global epidemiological studies, highlight the urgent need for wider screening, early diagnosis, and preventive interventions.
The High-Risk Surge: More Than 1 in 2 at Risk
A pooled analysis of 50 studies involving more than 26,000 participants paints an even more concerning picture. It found that approximately 38.6% of Indian adults are living with non-alcoholic fatty liver disease (NAFLD), the previous term used for the condition. Among individuals already at high metabolic risk, including those with obesity or type 2 diabetes, the prevalence rises dramatically to 52.8%, suggesting that more than one in every two people in these groups may have fatty liver disease.
Alarm Bells for the Next Generation
The growing burden is not limited to adults. Children are also increasingly being diagnosed with fatty liver disease, reflecting changing dietary habits, reduced physical activity, and rising childhood obesity. According to the same analysis, the pooled prevalence among children stands at 35.4%, increasing sharply to 63.4% among children with obesity. Health experts warn that early-onset fatty liver disease significantly increases the lifetime risk of chronic liver disease, cardiovascular complications, and metabolic disorders.
Also Read: Fatty Liver Crisis In India: Why Are Non-Alcoholics At Risk?
From Desk Workers to Rural Communities
Research also indicates that the disease cuts across geographic, occupational, and socioeconomic boundaries. Studies have identified a particularly high burden among India's IT workforce, where prolonged sitting, irregular eating habits, stress, and lack of physical activity contribute to metabolic dysfunction. Regional studies conducted in Karnataka and northern India have similarly reported high prevalence rates in both urban and rural populations, with central obesity, insulin resistance, and diabetes consistently emerging as the strongest risk factors.
The Diagnostic Deficit
Despite the scale of the problem, awareness and clinical management remain inadequate. A nationwide survey of hepatologists published earlier this year highlighted considerable gaps in the diagnosis and management of fatty liver disease across healthcare settings. Experts believe that many individuals continue to remain undiagnosed because the disease often progresses silently, causing little or no symptoms until significant liver damage has already occurred.
Connecting the Dots: Integrated Screening Opportunities
The rise in MASLD closely mirrors India's increasing burden of lifestyle diseases. As rates of obesity, diabetes, hypertension, and metabolic syndrome continue to climb, liver disease has become an important component of the country's non-communicable disease challenge. Public health specialists believe this overlap also presents an opportunity. Individuals being evaluated for diabetes or cardiovascular disease can simultaneously be screened for fatty liver disease, allowing healthcare providers to identify at-risk patients earlier and initiate lifestyle interventions before irreversible liver damage develops.
The Power of Prevention
Experts stress that prevention remains the most effective strategy. Maintaining a healthy body weight, following a balanced diet, engaging in regular physical activity, limiting consumption of ultra-processed foods and sugary beverages, and effectively managing diabetes and high blood pressure can significantly reduce the risk of developing fatty liver disease or slow its progression.
A Call to Action for Public Health
With projections suggesting that the burden of fatty liver disease will continue to rise over the coming decade, researchers are urging policymakers and healthcare systems to strengthen surveillance, adopt standardized diagnostic criteria, and expand community-based screening programmes, particularly in underserved and rural regions. Without timely intervention, experts warn that India could see a substantial increase in advanced liver disease, cirrhosis, liver cancer, and the associated healthcare burden in the years ahead.
(By Dr. Piyush Vishwakarma, Consultant- Gastroenterology, Hepatology & Liver Transplant, RG Hospitals Delhi)
Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.