Non-Alcoholic Fatty Liver Disease (NAFLD) is no longer a disease confined to urban, office workers. it spread quietly across rural India, among the poor and hard-working population. Recent meta-analyses show that approximately 38% of Indian adults have NAFLD, with a prevalence of around 29% even in rural areas. Emerging patterns now point to a dual reality: sedentary professionals in cities and manual laborers in villages converge on a common risk of metabolic dysfunction, poor nutrition, alcohol use, and sleep disorders. A striking survey in Hyderabad supported by the ICMR found a staggering 84% of IT professionals with fatty liver, highlighting the extraordinary prevalence of this ‘silent epidemic’.
This shift forces a need to reconsider: NAFLD is primarily a lifestyle disease, not just an occupational hazard associated with desk work. Many factors are changing the state of liver health in India, from lean-but-fat profiles to changing dietary patterns and urbanization of rural diets. To understand why fatty liver is on the rise across demographics and how it can be detected, managed and prevented, Firstpost spoke to Dr KS Somasekhar Rao, Senior Consultant Gastroenterologist, Hepatologist and Advanced Therapeutic Endoscopist at Yashoda Hospitals, Hyderabad to shed light on the growing crisis and the path to prevention.
Excerpts:
Why Fatty Liver Beats a Desk Job
Dr. Somasekar: Previously, fatty liver disease was observed mainly in urban workers. But it is now on the rise, even in rural areas, due to lifestyle changes and diets high in refined carbohydrates, fried foods and sugary drinks, combined with less physical activity after work. Many farm workers also skip a balanced diet and depend on alcohol or processed foods, which impairs liver health. It is no longer just idleness; it is about nutritional imbalances, alcohol consumption and metabolic changes. This shift reminds us that fatty liver disease is a lifestyle disease, not just an occupational one.
Why are IT professionals prone to fatty liver?
Dr. Somasekar: An ICMR-backed Hyderabad study showing 84% prevalence among IT professionals is alarming but not surprising. A long sedentary lifestyle, irregular meal times, minimal exposure to sunlight, chronic stress and insufficient sleep create a perfect storm for metabolic syndrome and fat build up in the liver. Many skip breakfast, snack on semi-finished products and do sports irregularly. These habits disrupt the body’s circadian rhythm and insulin response, directly affecting liver metabolism. The solution lies in structured routines, nutritious food choices, screen breaks and regular exercise— small changes that can have a big impact on liver health.
What is “skinny but fatty” liver disease?
Dr. Somasekar: Lean but fatty liver occurs when metabolic dysfunction develops despite a normal body weight. Genetics, high-carbohydrate diets, insulin resistance, stress, and visceral fat (fat around the organs) can cause fat to accumulate in the liver, even in slim people. Many thin people falsely believe they are safe, but they may have high cholesterol or high blood sugar. Regular examinations, analysis of liver function and ultrasound are necessary. Eating a balanced diet, limiting sugar and refined carbohydrates, managing stress, and staying active help prevent this silent condition. Weight alone does not determine metabolic health, lifestyle does.
How to detect fatty liver in time?
Dr. Somasekar: Fatty liver often does not leak, making early detection difficult. However, minor signs such as unexplained fatigue, dull discomfort in the abdomen (especially on the right side), loss of appetite, mild bloating or weight gain around the abdomen should not be ignored. In some, liver enzyme levels rise before visible symptoms appear. Regular health reviewsespecially for those with diabetes, obesity or high cholesterol are critical. Early detection with a simple ultrasound or liver profile analysis can prevent the development of fibrosis, cirrhosis or liver cancer. Remember – you may not feel it, but your liver does.
How can fatty liver disease be eliminated?
Dr. Somasekar: Fatty liver can be reversed in the early stages by changing your lifestyle. A balanced diet rich in fruits, vegetables, lean proteins and whole grains, along with reduced sugar, refined carbohydrates and fried foods, is key. Avoid alcohol completely, maintain regular meal times, and stay hydrated. Do at least 30-45 minutes of brisk walking or exercise daily. For rural residents, it is effective to replace fatty or sweet foods with fresh ones prepared at home. Regular fibroscanning reviews every 6-12 months help monitor progress. The message is simple: eat smart, exercise daily and get tested regularly.
How can awareness help prevent fatty liver disease?
Dr. Somasekar: Fatty liver is now a health problem, not just a lifestyle problem. Governments and health systems should prioritize screening programs, awareness raising and nutrition education in schools and workplaces. Primary medical care centers should offer affordable liver health screenings. Workplaces, especially in the IT and corporate sectors, should promote active workplaces, mental health support and healthy cafeteria options. Collaboration between health experts and employers can facilitate large-scale prevention. The focus must shift from treatment to early detection and lifestyle changes, ensuring everyone has access to liver health awareness.
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