38% of Indians have fatty liver: Doctor suggests 5 signs of fatty liver one can check at home

A silent health concern is gripping India; nearly 38% of adults are now estimated to have Non-Alcoholic Fatty Liver Disease (NAFLD). What makes this condition worrying is that it often develops quietly, without dramatic symptoms. Gastroenterologist Dr Saurabh Sethi (MD, MPH) says that even though a proper diagnosis requires medical tests like ultrasounds or liver function tests, there are some early physical and lifestyle signs that can raise suspicion, and many can be noticed right at home.

Fatigue in fatty liver disease isn’t ordinary tiredness. It’s a constant sense of low energy, even after adequate rest. The liver plays a key role in converting nutrients into energy. When fat builds up inside it, this energy process slows down. Over time, one might feel drained, heavy, or sluggish, especially during the day. It’s often dismissed as stress or overwork, but when tiredness becomes a daily companion, it may be worth paying closer attention.

One of the most telling signs of a fatty liver is central obesity, a gradual accumulation of fat around the abdomen. Even those who appear otherwise lean might notice that the waistline feels tighter. Dr Sethi points out that fat stored around the liver and internal organs is far more harmful than the one beneath the skin. This “hidden” fat is often linked with insulin resistance and poor metabolic health, both early warnings for NAFLD.

That occasional discomfort or mild pain on the right side of the abdomen, just under the ribs, can sometimes indicate that the liver is swollen or inflamed. It’s not always sharp pain, more often, it feels like pressure, heaviness, or fullness. Since the liver sits on the right side, such sensations shouldn’t be ignored, especially when they appear alongside fatigue and weight gain.

Fatty liver disease is deeply tied to insulin resistance, when the body’s cells stop responding efficiently to insulin. This can quietly show up in daily life as increased hunger after meals, sudden energy crashes, or darkened patches of skin, especially around the neck or underarms (a condition called acanthosis nigricans). These small clues often appear long before blood sugar levels rise to diabetic ranges.

When the liver struggles to process fats and toxins, it can cause digestive discomfort. A feeling of queasiness, early fullness after meals, or a general disinterest in food can be subtle indicators. Dr Sethi explains that these symptoms result from the liver’s reduced ability to handle dietary fats efficiently. Over time, the digestive rhythm feels off-balance, not enough to trigger alarm, but enough to signal something’s not quite right.

This article is for informational purposes only and not a substitute for professional medical advice. Fatty liver disease can only be confirmed through proper medical evaluation, such as liver imaging and blood tests. Always consult a qualified doctor for diagnosis or treatment.

To keep your liver healthy, avoid junk food, exerise, quit alcohol, and eat liver friendly foods.

Do not ignore Fatty Liver disease as it can progress to more serious complications in the future.

The essential difference between Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic Fatty Liver Disease (NAFLD) lies in their primary cause: AFLD is a direct result of chronic, excessive alcohol consumption, where the liver's attempt to break down alcohol produces toxic byproducts that lead to fat accumulation and cell damage.

Conversely, NAFLD (now often called Metabolic Dysfunction-Associated Steatotic Liver Disease or MASLD) occurs in individuals who consume little to no alcohol, and is instead strongly linked to metabolic risk factors like obesity, insulin resistance, type 2 diabetes, and high cholesterol. Early diagnosis and lifestyle changes are crucial to prevent disease progression and complications. A balanced diet and regular exercise can help as well.