Alarming Rise in Liver Disease Among Young Indians, Doctors Warn of Public Health Crisis
New Delhi: A disturbing trend is emerging across India as doctors report a sharp increase in liver disease among young adults, with individuals as young as 22 years old presenting abnormal liver tests despite no visible health issues. On World Liver Day, medical specialists sounded the alarm, labeling this a fast-growing public health crisis that the nation can no longer afford to ignore. The primary driver behind this surge is lifestyle-related metabolic disorders, which are becoming increasingly prevalent in the younger population.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) on the Rise
Doctors emphasize that Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), once primarily associated with middle age, is now being diagnosed more frequently in people in their early 20s. This shift is fueled by sedentary lifestyles, poor dietary habits, and rising metabolic risks. Dr. SK Sarin, director of the Institute of Liver and Biliary Sciences (ILBS), highlighted this trend, stating that data clearly show a growing burden of fatty liver disease among young Indians. "This is a clear and alarming trend backed by evidence," he said.
Shocking Prevalence Rates and Data Insights
Citing a 2024 Delhi-based survey conducted across community health centres, Dr. Sarin revealed that 56% of those screened were found to have fatty liver disease. "One in two people had fatty liver, including 11% who were lean and not obese, challenging the common belief that the disease affects only overweight individuals," he explained. He added that obesity rates escalate sharply with age, from around 3% in children under five to nearly 15% by the age of 12, indicating that metabolic risk begins early in life.
Data from the SMILES (Stronger India through Million Health Educated Students) programme further underscores the concern. Among over 43,000 participants aged 18–25, fatty liver, high blood pressure, and sedentary behaviour were increasingly common, with nearly 40% reporting they did not even walk for 40 minutes a day.
Understanding MASLD and Its Progression
Dr. Sanjiv Saigal of Max Super Speciality Hospital, Saket, explained that MASLD results from fat accumulation in the liver in individuals with risk factors such as obesity, diabetes, and abnormal cholesterol levels. "If unchecked, it can silently progress from simple fat deposition to inflammation, fibrosis, cirrhosis, and even liver cancer," he warned.
Describing the situation as a "perfect storm," Dr. Bhushan Bhole of PSRI Hospital pointed to genetic predisposition, unhealthy diets, physical inactivity, and early-onset metabolic disorders as key drivers. "At least one in four young Indian adults aged 18–35 now show signs of MASLD or elevated liver enzymes," he said, adding that Indians are especially vulnerable due to a tendency to accumulate visceral fat even at normal body weight—a condition referred to as "lean MASLD."
Hidden Risks and Environmental Factors
Air Cmde (Dr) Bhaskar Nandi of Sarvodaya Hospital noted that the disease often goes unnoticed. "Even normal-weight individuals can carry significant liver risk due to hidden visceral fat and insulin resistance," he said, describing MASLD as "a disease of late-night eating, prolonged sitting, and chronic sleep disruption."
Clinical observations are supported by robust data. A 2025 multicentric Indian study involving over 13,000 adults found fatty liver prevalence as high as 68%, with one in three already showing signs of liver fibrosis. The burden was highest in north India, and age was not a limiting factor, with young adults equally affected.
Environmental factors are further compounding the risk. Dr. Bhole pointed to studies linking exposure to air pollution, particularly PM2.5, with liver inflammation and fat accumulation.
Prevention and Reversibility: A Ray of Hope
Despite the worrying trend, doctors stress that MASLD is preventable—and even reversible—if detected early. "A weight loss of just 5–7%, healthier eating, and regular physical activity can significantly reduce liver fat," Dr. Bhole said, adding that routine screening is crucial for those with risk factors such as abdominal obesity or diabetes.
"The liver has a remarkable ability to regenerate," Dr. Saigal concluded, "But only if we act in time." This message underscores the urgent need for public awareness and proactive health measures to combat this escalating crisis among India's youth.
