India’s Silent Liver Crisis: Fatty Liver Cases Surge Since 1990, Blame Diabetes and Obesity

India is facing a silent but rapidly escalating liver health crisis, with new data from The Lancet Gastroenterology and Hepatology highlighting a sharp rise in metabolic dysfunction-associated steatotic liver disease (MASLD), also commonly known as fatty liver disease. Once considered rare and linked mainly to alcohol, the condition is now being driven by diabetes, obesity, and modern lifestyles. According to the Global Burden of Disease (GBD) analysis published in The Lancet, fatty liver disease has increased dramatically since 1990, both globally and in India. Worldwide cases have surged by 143 per cent, reaching nearly 1.3 billion people in 2023, with projections suggesting this could rise to 1.8 billion by 2050. India mirrors this worrying

trend. The country has seen a 23 per cent rise in MASLD prevalence between 1990 and 2023, with rates climbing from 10,191 to 12,555 cases per 100,000 people. Experts say it means that millions of Indians, many even unaware, are living with a condition that can quietly progress to cirrhosis, liver failure, or even liver cancer.Also read: Love Korean Buldak Noodles? This Spicy Habit Can Trigger Severe GERD, Ulcers, and Digestive Issues

The real culprits are diabetes and obesity

The study identifies high blood sugar or diabetes and high body mass index (BMI) as the leading drivers of fatty liver disease. India, often known as the “diabetes capital of the world,” is particularly vulnerable. Rising consumption of processed foods, sugary diets, and sedentary lifestyles has created the perfect storm for metabolic disorders. Experts note that insulin resistance, a hallmark of type 2 diabetes, plays a central role in fat accumulation in the liver. Over time, this can lead to inflammation and permanent liver damage.

A disease affecting younger Indians

One of the most alarming findings is that fatty liver disease is increasingly affecting younger adults, not just older populations. Rapid urbanisation, desk jobs, and reduced physical activity are accelerating risk in people as young as their 30s. In some Indian urban populations, prevalence rates range from 9 to 32 per cent, with certain regions reporting rates as high as 60 per cent. Even more concerning, many patients are non-drinkers, challenging the long-held belief that liver disease is primarily alcohol-related.

Why is MASLD called a silent disease?

Fatty liver disease often shows no symptoms in its early stages, making it difficult to detect without screening. Many people discover it only during routine health check-ups or when complications arise. Despite the rising number of cases, the overall disease burden has remained relatively stable, suggesting that better diagnosis and management are helping delay severe outcomes, but not reducing the number of people affected.

Can this crisis be reversed?

The good news is that MASLD is largely preventable and reversible in its early stages. Health experts recommend:

• Maintaining a healthy weight
• Managing blood sugar levels
• Reducing processed and high-sugar foods
• Exercising regularly
• Avoiding excessive alcohol