Tackling the fatty liver disease epidemic

Tackling the fatty liver disease epidemic


International Fatty Liver Day, observed annually in June, carries the theme “Act Now, Screen Today” this year, reflecting an urgent call to action. While traditionally, liver diseases were predominantly linked to excessive alcohol consumption, a new threat has emerged: non-alcoholic fatty liver disease (NAFLD).

  • This condition, now reclassified as Metabolic dysfunction-associated steatotic liver disease (MASLD), is intricately linked to metabolic health and poses significant risks to cardiac health and cancer development. The imperative now is to screen, test, and treat effectively.


GS-02 (Health, Government policies and interventions)

Dimensions of the Article:

  • The Background
  • What is NAFLD?
  • Consequences
  • Why Address this Issue?

The Background

  • Liver diseases were historically associated with alcohol use, but recent years have seen a rise in NAFLD, now known as MASLD.
  • This shift in understanding underscores the disease’s link to metabolic health, making it a critical public health issue.
  • MASLD is expected to become the leading cause of chronic liver disease and the primary reason for liver transplants globally.
  • In 2022, a meta-analysis showed a 38.6% prevalence of fatty liver among Indian adults and 36% among obese children. This condition is closely associated with metabolic syndrome, including obesity, diabetes, high blood pressure, and abnormal cholesterol levels.
  • Factors like excessive carbohydrate intake and insulin resistance play significant roles in the disease’s progression.

What is NAFLD?

  • NAFLD represents a spectrum of liver conditions characterized by the accumulation of fat in the liver cells without significant alcohol use or other secondary causes.
  • Key points about NAFLD include:
    • Spectrum of Diseases: Ranges from simple fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer.
    • Fat Accumulation: Occurs when excessive fat builds up in liver cells.
    • Steatohepatitis: Inflammation and fat accumulation in the liver, leading to more severe liver damage.
    • Cirrhosis: Advanced scarring of the liver, causing irreversible damage.
    • Cardiovascular Risk: NAFLD is an independent predictor of cardiovascular diseases, type 2 diabetes, and other metabolic syndromes.
    • Prevalence: Affects 9% to 32% of the Indian population, with higher rates among those with obesity and diabetes.
    • Incurable: No specific cure exists once the disease develops, making prevention and health promotion crucial.


  • High Fatality Rate: The global burden of NASH has doubled over the last two decades, leading to increased cases of compensated cirrhosis.
  • Severe Liver Damage: Progressive liver conditions like steatohepatitis and cirrhosis severely impair liver function.
  • Metabolic Disorders: Strongly associated with obesity, diabetes, hypertension, and abnormal cholesterol levels.
  • Cardiovascular Risks: Increases the risk of heart diseases and other metabolic syndromes.
  • Quality of Life: Leads to significant morbidity and affects the overall quality of life.
  • Economic Burden: The growing prevalence of NAFLD poses a substantial economic burden on healthcare systems due to the costs of treatment and management.

Why Address this Issue?

  • Addressing NAFLD is crucial due to its widespread impact on public health and the healthcare system.
  • Early detection and intervention can prevent the progression to more severe liver diseases and associated complications.
  • It also highlights the need for comprehensive healthcare strategies that focus on prevention, early diagnosis, and effective management.

Suggested Measures

To combat the growing burden of NAFLD, several measures can be suggested:

  • Early Screening: Implement comprehensive health screenings, including physical examinations, blood tests, and abdominal ultrasounds, to detect fatty liver at an early stage.
  • Public Awareness: Increase public awareness about the risks of NAFLD and the importance of early screening and lifestyle modifications.
  • Personalized Healthcare: Develop personalized healthcare strategies based on individual risk factors such as family history, lifestyle, and pre-existing health conditions.
  • Diet and Exercise: Promote healthy dietary habits and regular physical activity to reduce the risk of developing NAFLD.
  • Medical Interventions: Use advanced liver tests like liver fibrosis assessment and vibration-controlled transient elastography for accurate diagnosis and monitoring.
  • Government Initiatives: Strengthen government initiatives like the NPCDCS programme and Ayushman Bharat scheme to encourage early diagnosis, behavior changes, and capacity building in healthcare.
  • Preventive Health: Shift the focus from diagnostic cure to preventive health through campaigns like ‘Eat Right India’ and ‘Fit India Movement’.

Way Forward

  • Integrated Strategies: Combine dietary modifications, regular physical activity, and effective weight management to mitigate liver disease risks.
  • Healthcare Infrastructure: Improve healthcare infrastructure to facilitate comprehensive screenings and advanced diagnostic tests.
  • Policy Implementation: Ensure effective implementation of government policies aimed at preventing and controlling NAFLD.
  • Research and Development: Invest in research to better understand NAFLD and develop new treatment strategies.
  • Community Engagement: Engage communities in awareness campaigns and encourage proactive health measures.
  • Global Collaboration: Collaborate with international health organizations to share best practices and strategies for managing NAFLD.