Delhi: Once considered a condition of the elderly, non-alcoholic fatty liver disease (NAFLD) is now increasingly affecting young adults in India, particularly those in sedentary professions, posing a significant public health challenge.  Non-alcoholic fatty liver disease (NAFLD), now reclassified as metabolic dysfunction-associated steatotic liver disease (MASLD), is emerging as a significant health concern among young Indians, especially those engaged in sedentary occupations. Recent studies indicate a sharp rise in prevalence, with lifestyle factors such as prolonged sitting, poor dietary habits, and lack of physical activity being primary contributors.

"A study conducted by the University of Hyderabad revealed that over 80% of IT professionals suffer from MASLD, with 71% classified as obese and 34% diagnosed with metabolic syndrome. These findings underscore the impact of sedentary work environments and unhealthy lifestyles on liver health." Dr. Ankur Garg, Director & Senior Consultant, Centre for Liver-GI Diseases and Transplantation (CLDT), Aakash Healthcare.

The high prevalence of MASLD among IT professionals is a wake-up call. The combination of long working hours, physical inactivity, and poor dietary choices is taking a toll on the younger workforce.

A Silent Progression

NAFLD often develops quietly, with fat gradually accumulating in the liver. In its early stages, it may not cause any noticeable symptoms, making it difficult to detect without medical screening. However, the disease can escalate to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, or even liver cancer if left untreated.

“The liver is a resilient organ, but this resilience often means that damage goes unnoticed until it’s too late. By the time patients come to us with symptoms like fatigue, abdominal discomfort, or unexplained weight loss, significant damage may already have occurred.” Dr. Amit Miglani, Director & HOD – Gastroenterology, Asian Hospital.

Not Just the Obese

While obesity, diabetes, and high cholesterol remain common risk factors, doctors are observing an increasing number of NAFLD cases among non-obese individuals. This emerging trend points to the multifactorial nature of the disease, with genetics, insulin resistance, and visceral fat playing critical roles.

"Fatty liver is no longer a disease confined to those who are overweight or diabetic. We’re now diagnosing young, seemingly healthy professionals who barely show any symptoms until the condition is in an advanced stage. Many of our patients with fatty liver have a normal BMI but still show signs of metabolic dysfunction. This tells us that lifestyle choices and genetic predisposition can be just as damaging as excess weight.” Dr Abhishek Yadav, Consultant and Director - HPB and Liver Transplant Surgeon, Jupiter Hospital.

Lifestyle at the Core

Experts agree that the modern sedentary lifestyle is a major contributor to this rise. Prolonged sitting, lack of exercise, and diets high in processed foods all contribute to fat buildup in the liver. These habits are particularly prevalent among India’s urban youth, whose workdays are dominated by screens and minimal physical movement.

“Sedentary behavior reduces insulin sensitivity, leading to insulin resistance—one of the key drivers of NAFLD. Unfortunately, our current work culture encourages long hours at desks with little regard for movement or nutrition.” added Dr. Ankur Garg.

The Gut-Liver-Brain Axis

Emerging research suggests that fatty liver disease, particularly in its advanced stages, can have a profound impact on neurological health. The liver plays a critical role in filtering toxins from the blood, and when its function is compromised, harmful substances like ammonia can accumulate and affect brain function, Dr Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital said.

"There’s growing evidence that the gut-liver-brain axis is significantly affected in patients with NAFLD. When liver health deteriorates, it can lead to subtle but chronic neurological disturbances that often go unnoticed until they worsen like memory lapses, difficulty concentrating, slowed thinking, mood changes, irritability or depression, and disturbed sleep patterns. In more severe cases, coordination problems or tremors may occur," Dr Gupta explained.

Call for Early Screening and Prevention

Health experts are urging primary care providers to incorporate liver function tests into routine health check-ups, particularly for those with risk factors. Policymakers are also being called upon to support public health awareness campaigns and fund research initiatives to better understand the spread and impact of NAFLD in India’s diverse populations.

“We need to shift focus from treatment to prevention. Simple lifestyle modifications like 30 minutes of daily exercise, reducing processed food intake, and consuming more fiber-rich diets can go a long way in preventing fatty liver disease.” Dr Aakaar Kapoor, CEO & Lead Medical Advisor City  XRay and Scan Clinic Pvt Ltd.

As India’s youth faces the consequences of an increasingly sedentary lifestyle, experts stress that the time to act is now. Early intervention, lifestyle changes, and regular medical check-ups could help curb the growing burden of fatty liver disease before it becomes an irreversible crisis.