Hyderabad, India – A significant proportion of adults in Hyderabad are grappling with fatty liver disease, a condition increasingly linked to lifestyle factors rather than alcohol consumption. A recent study reveals that over 40% of adults in the city have metabolic dysfunction-associated steatotic liver disease (MASLD), a figure slightly above the national average of 38.9%.

The research, published in ‘The Lancet Regional Health,’ surveyed over 10,000 adults across 27 Indian cities. In Hyderabad, the prevalence was particularly notable, with nearly half of men (46%) and over a third of women (36.2%) affected. This surge is attributed to sedentary lifestyles, irregular eating habits, the consumption of processed foods and a rise in metabolic disorders – all characteristics of modern urban living.

Delhi and Chennai recorded the highest prevalence rates among major metropolitan areas, at 41.3% and 41.2% respectively. Bengaluru followed closely with 40.6%, placing Hyderabad among the most affected large cities in India.

The Role of Obesity and Metabolic Risk Factors

Obesity is emerging as a primary risk factor for MASLD. The study found that individuals with class-2 obesity had nearly 14 times the risk of developing the condition compared to those with a normal weight. Diabetes doubled the risk, and conditions like hypertension and abnormal cholesterol levels further increased vulnerability. Importantly, doctors are also observing cases of “lean fatty liver,” where individuals with a normal body weight develop the disease due to underlying metabolic risks such as diabetes or excess abdominal fat.

Data from a 2025 survey conducted by the Asian Institute of Gastroenterology underscores the growing scale of the problem. The survey revealed fatty liver disease in over 25% of urban residents and approximately 20% of rural populations. Notably, the prevalence soared to 84% among IT employees, a demographic characterized by prolonged periods of sitting and high levels of stress.

From Silent Condition to Rising Cancer Risk

The consequences of untreated fatty liver disease extend beyond liver health. City specialists are reporting a visible increase in cases of hepatocellular carcinoma (HCC), the most common type of primary liver cancer. Weekly diagnoses have nearly doubled in recent years.

“HCC is often caused by cirrhosis, alcohol abuse, viral infections like hepatitis B and C, and increasingly, fatty liver diseases linked to obesity and diabetes,” explains Dr. Mukta Srinivasulu, former director of MNJ Cancer Hospital. “The obesity epidemic, sedentary lifestyle, and poor diet are now major contributors.”

Dr. Anand Kulkarni, a senior consultant hepatologist at AIG Hospitals, has observed a shift in the age of patients presenting with liver cancer. “We are seeing that nearly 40–50% of our liver cancer patients are relatively young. Many come late, often with large tumours and sudden severe abdominal pain. Diabetes is a common underlying factor. MASLD, obesity and diabetes are closely linked, while alcohol remains another significant cause,” he said, adding that fatty liver disease has surpassed viral hepatitis as a leading driver of serious liver complications.

Reversibility and the Need for Early Detection

Despite the concerning trends, experts emphasize that fatty liver disease is often reversible, particularly when detected early. “Fat in the liver is a warning sign. It can double the risk of heart disease and significantly raise the risk of heart failure,” says Dr. Kulkarni. “Early detection is key, as fatty liver can be reversed within 3 to 6 months. Even early fibrosis can improve within 8 to 10 months with proper treatment and lifestyle changes.”

The growing burden of fatty liver disease poses a potential strain on India’s healthcare system. If left untreated, the condition can progress to fibrosis, cirrhosis, cancer, and cardiovascular disease.

Public Health Initiatives and AI-Based Screening

Health officials are exploring the implementation of artificial intelligence (AI)-based screening in public hospitals to identify high-risk individuals more efficiently. The goal is to analyze routine health data to pinpoint those at risk of fatty liver disease, enabling earlier referral for evaluation and care. This approach aims to make screening more accessible, affordable, and scalable alongside existing non-communicable disease interventions.

The consensus among medical professionals is clear: fatty liver disease is no longer a silent, harmless condition. It represents a rapidly growing public health threat deeply rooted in everyday lifestyle choices. Addressing this requires a focus on preventative measures, early detection, and comprehensive management of metabolic risk factors.