Fatty liver means fat has built up in your liver. It is very common in India, it usually causes no symptoms, and it is often linked to extra weight around the waist, diabetes and PCOS. The NHS says it can usually be treated with healthy lifestyle changes: gradual weight loss if you need it, regular exercise and a balanced diet. You will see it called NAFLD (non-alcoholic fatty liver disease) or, now, MASLD.
How common is it in India?
A 2022 review pooled 50 Indian studies with more than 23,000 adults. It estimated that about 38.6% of adults had fatty liver, roughly 1 in 3. Among people at higher risk, such as those with obesity, diabetes or heart disease, it was about 53%. So if your ultrasound report mentions fatty liver, you are far from alone.
Are you at risk?
According to the NHS, you are more likely to get fatty liver if you:
- Are overweight, particularly with a lot of fat around your stomach and waist.
- Don’t have a healthy diet or aren’t very physically active.
- Have type 2 diabetes.
- Have polycystic ovary syndrome (PCOS).
- Have high blood pressure or high cholesterol.
- Are over 50.
Many of these go together, which is why fatty liver often shows up alongside insulin resistance and prediabetes and belly fat. Check your waist too: our BMI and waist guide explains the 80 cm cut-off for Indian women.
Symptoms
The NHS says fatty liver doesn’t usually cause any symptoms, and many people have it without realising. It is usually found when you have tests for another reason. Some people feel very tired, feel generally unwell, or have pain or discomfort under the right side of the ribs.
The 4 stages
The NHS describes four stages. Most people only have the first.
| Stage | What it means |
|---|---|
| 1. Fatty liver (steatosis) | Fat has built up, but there is no damage to the liver. |
| 2. MASH (previously NASH) | The fat has caused inflammation. The liver isn’t seriously damaged yet, but there is a risk it could get worse. |
| 3. Fibrosis | There is some damage (scarring), but the liver usually still works well. The aim is to stop further damage. |
| 4. Cirrhosis | Severe damage that affects how well the liver works, and can lead to serious health problems. |
A small number of people move to the later stages, and lifestyle changes can help prevent this. That is why a “mild” result is worth acting on now.
The tests
The NHS says fatty liver is usually found on blood tests or scans done for another reason. If your doctor thinks you may have it, they will usually ask about your symptoms and alcohol, check your weight and waist, and may arrange:
- More blood tests, including liver tests.
- An ultrasound scan of your tummy, to confirm the fat build-up.
- Tests to check for liver damage and to rule out other causes.
Once you have a diagnosis, the NHS suggests check-ups at least once a year and tests every 2 to 3 years to monitor it. Ask your doctor what your own results mean and how often to recheck.
What helps
Lose weight gradually, if you need to
NIDDK says losing at least 3% to 5% of your body weight can reduce fat in the liver, and losing up to 7% to 10% may be needed to reduce inflammation and scarring. For a 70 kg woman, 5% is 3.5 kg and 10% is 7 kg. Do it slowly: NIDDK warns that rapid weight loss and malnutrition can make liver disease worse. India’s ICMR-NIN guidelines suggest about half a kilo a week.
Move every day, even before the scale moves
A review of 12 controlled trials found that regular exercise reduced liver fat, and that the benefit appeared with little or no weight loss, at exercise levels below what is usually recommended for weight management. NIDDK also says physical activity is helpful even without weight loss. The NHS advises at least 150 minutes of exercise a week. Brisk walking, dance cardio and strength work at home all count; our beginner’s home workout is a good place to start.
Eat a balanced Indian plate
- Half the plate vegetables and salad, as ICMR-NIN suggests.
- Dal, chana, paneer, curd, eggs or another protein at every meal.
- Whole grains and millets in sensible portions, instead of maida, white bread and biscuits.
- Much less added sugar, sweet drinks and juice, fried snacks and packaged foods.
Our Indian diet for weight loss guide shows how to balance the food you already cook.
Alcohol, smoking and supplements
- Alcohol: the NHS says not to drink too much. If you have fatty liver, ask your doctor how much, if any, is safe for you.
- Smoking: the NHS advises not to smoke.
- Supplements and “liver detox” products: NIDDK advises asking your doctor first, because some herbal remedies can damage the liver.
Fatty liver, PCOS and diabetes
PCOS and type 2 diabetes are both on the NHS list of risk factors, and the same habits help all three: gradual weight loss if you need it, regular strength and cardio exercise, and a balanced plate. See our PCOS guide and insulin resistance guide. The NHS notes that these lifestyle changes also lower the risk of heart disease, kidney disease, high blood pressure and type 2 diabetes.
When to see your doctor
- You think you could have fatty liver, or you have several of the risk factors above.
- A report mentions fatty liver or raised liver enzymes and nobody has explained it to you.
- You have pain under your right ribs, or feel very tired and unwell for no clear reason.
If your liver is damaged (fibrosis or cirrhosis), the NHS says you will need to see a liver specialist, as well as making the lifestyle changes.
How FunDa helps
The Superwoman Club works on the daily habits that matter here: strength and dance workouts at home, nutrition built around your ghar ka khana with dietitian support, sleep and stress routines, and daily check-ins. We coach healthy habits alongside your doctor’s care; we don’t diagnose or treat fatty liver, never ask anyone to change their medication, and results vary from person to person.
Sources
- NHS. Non-alcoholic fatty liver disease (NAFLD) (reviewed 31 July 2025).
- National Institute of Diabetes and Digestive and Kidney Diseases (NIH). Treatment for NAFLD & NASH (reviewed April 2021).
- Shalimar et al. Prevalence of non-alcoholic fatty liver disease in India: a systematic review and meta-analysis. J Clin Exp Hepatol. 2022;12(3):818-829.
- Keating SE et al. Exercise and non-alcoholic fatty liver disease: a systematic review and meta-analysis. J Hepatol. 2012;57(1):157-166.
- Bull FC et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020.
- ICMR-National Institute of Nutrition. Dietary Guidelines for Indians (2024).
How we write our guides: read our editorial and evidence policy.