NAFLD: Sober but still at risk

New Indian Express

09-07-2025

You may not feel it and there may be no symptoms at all. But deep inside your body, your liver could be quietly storing fat, even if you've never touched a drop of alcohol. That's the unnerving reality of non-alcoholic fatty liver disease (NAFLD), a condition that's crawling into more lives than ever, silently and steadily.
What exactly do you mean by NAFLD? 'It is a condition where fat builds up in your liver, for reasons other than alcohol,' says Dr Narendra Teja Gogireddy, consultant surgical gastroenterologist at Apollo Hospitals, Hyderguda, further adding, 'This term is used for patients with chronic lifestyle diseases. In initial stages it is mild and reversible, however it can cause liver damage over time and lead to serious conditions like cirrhosis or liver failure.'
The condition often stems from everyday habits that seem harmless at first; a sedentary routine, meals loaded with sugar and processed carbs, and that familiar struggle with weight gain. 'People who drink little or no alcohol may develop NAFLD. People who are overweight or obese frequently exhibit it. The most prevalent type of liver disease in the world today is NAFLD. Although NAFLD in its early stages is typically benign and asymptomatic, it can develop into more severe forms such as Non-Alcoholic Steatohepatitis (NASH), which involves damage and inflammation of the liver. NASH can result in cirrhosis, scarring (fibrosis), and potentially liver failure or malignancy if treatment is not received,' explains Dr Naveen Polavarapu, senior consultant, medical gastroenterologist, liver specialist, lead, advanced endoscopic interventions & training, clinical director, Yashoda Hospitals, Hyderabad.
What's alarming is that NAFLD doesn't discriminate, 'Fat can build up in your liver even if you don't drink alcohol. This happens due to several factors like insulin resistance (often linked with type 2 diabetes or prediabetes), high cholesterol or triglyceride levels, poor diet (especially diets high in sugar and refined carbs), sedentary lifestyle (lack of physical activity), rapid weight loss or malnutrition, certain medications (like corticosteroids or some cancer drugs), hormonal imbalances or metabolic syndrome. These risk factors can lead to fat accumulation in liver cells, potentially causing inflammation, scarring, and liver damage over time if not managed,' says Dr Narendra.