The study, led by the Council of Scientific and Industrial Research (CSIR), surveyed over 10,000 adults across 27 cities. In Hyderabad, nearly half of men (46%) and over a third of women (36.2%) were found to have fatty liver disease. Doctors attribute the surge to sedentary lifestyles, irregular eating patterns, processed food consumption and rising metabolic disorders — patterns closely associated with urban living. Delhi tops the chartsAmong major metros, Delhi recorded the highest prevalence at 41.3%, followed by Chennai at 41.2%. Bengaluru reported 40.6%, placing Hyderabad among the most affected large cities. Obesity emerged as the strongest risk factor. People with class-2 obesity had nearly 14 times higher risk of developing MASLD compared to those of normal weight. Diabetes doubled the risk, while hypertension and abnormal cholesterol further increased vulnerability. Doctors also warn of ‘lean fatty liver,’ where individuals with normal body weight develop the disease due to hidden metabolic risks such as diabetes or excess abdominal fat, challenging the belief that only overweight people are affected. A 2025 survey by the Asian Institute of Gastroenterology highlights the scale of the problem. It found fatty liver disease in over 25% of urban residents and about 20% in rural populations, with prevalence among IT employees — characterised by prolonged sitting and high stress — soaring to 84%. Sedentary lifestylesCity specialists say the fallout is already visible in oncology wards. Cases of hepatocellular carcinoma (HCC), the most common primary liver cancer, are rising sharply, with weekly diagnoses nearly doubling in recent years. “HCC is caused by cirrhosis (scarring of the liver), alcohol abuse, viral infections like hepatitis B and C, and increasingly by fatty liver diseases linked to obesity and diabetes,” said Dr Mukta Srinivasulu, former director of MNJ Cancer Hospital. “The obesity epidemic, sedentary lifestyle and poor diet are now major contributors,” he said.Dr Anand Kulkarni, senior consultant hepatologist at AIG Hospitals, noted a shift in disease patterns. “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 has overtaken viral hepatitis as a major driver of serious liver complications. Condition is reversibleExperts warn the growing burden could strain India’s healthcare system. Untreated fatty liver can progress to fibrosis, cirrhosis, cancer and cardiovascular disease. Yet the condition is reversible if caught 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. Early detection is the 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,” Dr Kulkarni said. Health officials say the govt is now exploring artificial intelligence-based screening in public hospitals to identify high-risk individuals earlier. Public health threat“It is being discussed to deploy AI-enabled screening tools in public healthcare institutions that can quickly analyse routine health data to identify people at high risk of fatty liver, so they can be referred for further evaluation and care, making screening more accessible, affordable and scalable alongside other non-communicable disease interventions,” an official said. The message from doctors is clear: Fatty liver is no longer a silent, harmless condition but a fast-growing public health threat rooted in everyday lifestyle choices.
