Liver health is emerging as one of the most pressing yet under-recognised health challenges of our time. Long associated with alcohol use or viral infections, the risk landscape has shifted. A far more widespread threat is now taking centre stage: fatty liver.
Globally, metabolic dysfunction-associated steatotic liver disease (MASLD), earlier known as fatty liver, affected an estimated 1.3 billion people in 2023 and is projected to reach 1.8 billion by 2050.
Its rise is closely linked to the growing burden of obesity and diabetes, both of which are increasing rapidly in India. This makes the issue especially important for Indians and South Asians, who are known to be more vulnerable to abdominal fat accumulation and insulin resistance, often even at lower body weights. In simple terms, many people may look healthy on the outside but still carry a higher metabolic risk.
Fatty liver is particularly concerning because it develops quietly. With few early warning signs, fat accumulation can gradually cause inflammation, scarring, and, in advanced stages, cirrhosis, liver failure, or liver cancer. Liver health is closely interconnected with type 2 diabetes, cardiovascular risk, and wider metabolic dysfunction. In fact, fatty liver can both result from and worsen these conditions, creating a cycle that is difficult to break once it advances.
Too often, diagnosis happens only after significant progression, when treatment becomes more difficult and outcomes harder to improve.
Limitations of a Reactive Healthcare Approach
India already carries a significant liver disease burden. It is estimated that 50 to 70 million people in the country are living with chronic liver conditions, resulting in more than 200,000 deaths every year.
Liver conditions are often silent in their early stages. Many people do not experience pain or obvious symptoms. Mild abnormalities in liver function may go unnoticed. There is also a persistent belief that liver disorder is mainly associated with alcohol consumption, due to which, those with obesity, diabetes, poor diet, or sedentary lifestyles may not recognise that they are also at risk.
This is where current healthcare needs to step up. Delayed diagnosis often leads to more complex treatment and poorer outcomes.
The Shift Towards Prevention-First Care
People living with obesity, diabetes, high cholesterol or metabolic syndrome should also be assessed for liver risk. Integrating liver health into routine care can help identify disease earlier and enable timely treatment.
Driving Early Detection Through Risk-Based Screening and Community Engagement
For those at higher risk, liver assessment should move beyond general awareness to practical evaluation. Simple blood tests and liver profile evaluations can help detect warning signs earlier, especially when used as part of routine health monitoring.
Apart from testing, focusing on community awareness becomes critical. Healthcare professionals, public health systems, and awareness campaigns — all contribute to promoting regular, proactive monitoring.
Emerging New Therapies
Newer therapies such as resmetirom and semaglutide are expanding the treatment landscape for metabolic dysfunction-associated steatohepatitis (MASH), which also reflects scientific progress alongside the continued importance of lifestyle modification.
This changing treatment landscape is important because liver care can no longer be viewed only through the lens of prevention. Once fatty liver or MASH is suspected, the next step is not passive observation, but proper evaluation and continued management. For many patients, treatment begins with structured lifestyle changes such as weight reduction, healthier eating patterns, and regular physical activity. But management does not stop there. Doctors may also focus on improving blood sugar, cholesterol, and other metabolic risk factors that often drive liver disease progression.
At the same time, scientific progress is creating new possibilities. The emergence of newer therapies signals that treatment options for appropriate patients are beginning to expand beyond lifestyle advice alone. This is encouraging not only because it offers more hope, but because it reinforces a larger shift in how liver disease is being understood — as a condition that deserves timely attention, active management, and, where needed, a more targeted therapeutic approach.
For patients, this means the message is clear: do not ignore the condition simply because symptoms are absent. Seek medical advice early, undergo appropriate follow-up, and work with your doctor on a plan that may include weight management, better metabolic control, and discussion of evolving treatment options where relevant. Early action can make a meaningful difference to long-term liver health.
These developments are promising; however, they also highlight the larger aspect that liver disorders are serious, prevalent, and require early intervention.
Enabling a Sustainable Prevention Ecosystem for Long-Term Impact
Long-term impact will depend on building an ecosystem that supports prevention at every level. That includes healthcare providers, public health systems, industry, families, and communities working together to make liver health a routine part of preventive care.
Lifestyle changes such as healthier eating, increased physical activity, weight management, and reduced alcohol intake remain central to protecting liver health. Combined with greater awareness, risk-based screening, and timely follow-up, these measures can help reduce progression to cirrhosis and liver cancer while improving quality of life.
Reframing the Future of Liver Health
The future of liver health depends on initiating early treatment.
For India, that means building a culture where liver health is seen as an essential part of overall wellness. Early detection, timely intervention, and greater awareness can change outcomes for millions. If we act sooner, we can reduce the burden of advanced liver disorders and move closer to a healthier future built not just on treatment, but on prevention.
This authored article was first published in BW Healthcare World on July 2, 2026.
