The liver crisis you missed

It’s not your cheat day treats or weekend indulgences — it’s the everyday sugar bombs and sedentary sofa lifestyle (read Netflix marathons) that are sneakily wrecking your liver. And if you think only heavy drinkers need to worry about liver disease, think again.

Non-Alcoholic Fatty Liver Disease (NAFLD) — recently renamed Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) — is on the rise across the UAE, and not just in middle-aged adults. Young adults, teens, and even children are showing signs of liver fat buildup, driven largely by unhealthy eating habits and the near-total absence of movement in everyday life.

“The condition is closely associated with obesity, type 2 diabetes, and insulin resistance,” explains Dr Jayakumar B. Kannan, Consultant Gastroenterologist at Aster Clinic, Al Muteena (Deira). “It’s particularly alarming how significantly it’s growing among younger people.” He attributes this trend to sedentary lifestyles and the growing consumption of refined sugars, carbohydrates, saturated fats, and carbonated beverages.

Dr Sulieman Abdal Raheem, Staff Physician at the Digestive Disease Institute in Cleveland Clinic Abu Dhabi, agrees. “The UAE is seeing a surge in MASLD cases due to the increased prevalence of metabolic conditions such as obesity and diabetes,” he says. “Sedentary lifestyles combined with high intake of fast food, sugary drinks, and processed foods are major contributors.”

Call it a lifestyle disease, but MASLD is fast becoming a public health emergency. According to Dr Mazen Hamid, Consultant Gastroenterologist at Zulekha Hospital Sharjah, the core issue lies in the energy imbalance. “Excess energy intake and low physical activity levels lead to insulin resistance and increased circulating sugars and fatty acids in the blood,” he says. “This causes triglyceride build-up in the liver, eventually resulting in hepatic steatosis.”

And it’s not just about weight. Even those with a seemingly average BMI might be at risk, warns Dr Piyush Somani, Consultant Gastroenterologist and Head of Gastroenterology at PRIME Hospital. “It’s not always visible. People assume they’re healthy if they’re not obese — but fatty liver can creep in silently if you’re loading up on sweets, starch, soft drinks, and processed snacks,” he says. He points out that sugar-sweetened beverages, especially those with high-fructose corn syrup, are major culprits in rapidly increasing liver fat.

Children are not spared either. “Childhood obesity is one of our biggest concerns,” notes Dr Bharat Sapra, Consultant in Gastroenterology at Burjeel Medical City. “Nearly 40 per cent of children in the UAE are overweight. Add that to excessive screen time and sugary food habits, and you’ve got a generation already at risk for fatty liver disease.” He adds that more than 60 per cent of adults in the country lead sedentary lives — a figure that illustrates how deep-rooted the issue is.

The perfect recipe for fatty liver is a diet drowning in refined carbs and sugar, sprinkled with processed junk, and topped with no physical activity — and that’s a lifestyle fast becoming the norm in the UAE.

The condition may not trigger warning signs immediately, but untreated MASLD can lead to serious complications, including liver inflammation, fibrosis, and even cirrhosis. And since it often flies under the radar with no obvious symptoms, it’s essential for people — especially parents of young kids — to take proactive steps.

“Start with the basics,” advises Dr Kannan. “Incorporate regular exercise, limit junk food and sugar intake, and stay active daily. Prevention is far easier than cure.”

MASLD is sneaky, subtle, and surprisingly common. And while it’s often symptomless at first, doctors are urging people across the UAE to take those early whispers from the liver seriously.

“Most people with MASLD are asymptomatic,” says Dr Kannan. “But that doesn’t mean it isn’t damaging the liver quietly in the background.”

When symptoms do show up, they tend to be vague — like persistent tiredness, dull upper abdominal pain, and a general sense of weakness. “An enlarged liver is often detected during physical exams, but many people walk around with this condition for years without even knowing it,” Dr Kannan explains. He adds that both lean and obese individuals can be affected, shattering the myth that fatty liver is just a problem for those who are visibly overweight.

Dr Raheem calls MASLD “a silent disease,” often picked up accidentally during routine health check-ups. “You might feel some fatigue or slight discomfort in the upper abdomen, but that’s about it,” he says. “That’s why it’s critical for high-risk individuals — especially those with diabetes, obesity, or a family history of liver disease — to get screened regularly.” Blood tests, ultrasound scans, and doctor consultations are key tools in catching MASLD early, he adds.

The challenge lies in the fact that the liver suffers in silence, as Dr Hamid, explains. “In most cases, there are no symptoms in the early stages,” he says. “But over time, if left unchecked, the condition can progress to hepatosplenomegaly (enlargement of liver and spleen) or even liver cirrhosis.”

Dr Hamid strongly recommends early testing — even when symptoms are absent — especially for people with poor dietary habits and risk factors like central obesity, prediabetes, high triglycerides, hypertension, and a family history of liver disease. “Simple tests like LFT, lipid profile, HbA1c, abdominal ultrasound, and ECG can reveal a lot,” he says.

The stakes get higher when MASLD evolves into MASH — Metabolic Dysfunction-Associated Steatohepatitis — a more serious condition that can lead to liver fibrosis or cirrhosis. “At this point, symptoms become harder to ignore,” explains Dr Somani. “People may notice pain in the upper right side of the abdomen, significant fatigue, swelling in the belly, a loss of appetite, or even unexplained weight loss.”

One often overlooked but telling sign? Patches of darkened skin, which may appear as a result of insulin resistance, a known contributor to fatty liver disease. “These patches, especially around the neck or armpits, are more than just a cosmetic issue,” notes Dr Sapra. “They often signal advanced metabolic dysfunction and need medical evaluation.”

Dr Sapra also points to elevated liver enzymes in blood work as an early clue. “We often find abnormal readings when patients come in for unrelated conditions,” he says. “That’s why annual health check-ups are not just important — they’re essential.”

Ultimately, the message is clear: MASLD isn’t a life sentence — but your lifestyle could be. Whether it’s swapping your dessert for berries, walking instead of scrolling, or making your dinner plate more plant-based, your liver will thank you.

“This is one of the few chronic conditions where you can literally reverse the damage with consistent changes to your daily habits,” says Dr. Kannan. “Regular exercise — at least 45 minutes a day — and smart eating are key.” He recommends ditching sugary and carbonated drinks, skipping traditional sweets, and staying away from deep-fried snacks and fatty non-veg dishes. Instead, he advises patients to load up on salads, berries, green apples, and leafy vegetables while keeping pulp-heavy fruits to a minimum.

The consensus is to treat your liver to a Mediterranean-style makeover. “A diet rich in vegetables, legumes, whole grains, olive oil, and moderate amounts of fish works wonders for liver health,” says Dr Raheem. “MASLD is reversible in its early stages — but only if we address obesity, insulin resistance, and sugar overload head-on.” He also highlights the importance of 30 minutes of moderate exercise, five days a week, as recommended by the American Association for the Study of Liver Disease. In later stages, medication may be needed, but lifestyle remains the first line of defence.

So what exactly should your plate (and week) look like? Dr Shareej S, Specialist Gastroenterologist at Zulekha Hospital Dubai, lays it out like a prescription. “Go for whole, unprocessed foods — think spinach, kale, berries, salmon, legumes, quinoa, avocado,” he advises. “Limit fried food, processed meats, red meat, and sugary snacks.” He also recommends increasing omega-3s through nuts, seeds, and fatty fish.

Exercise? “Aim for at least 150 minutes of moderate activity per week — brisk walking, cycling, or swimming,” Dr Shareej says. He’s also a fan of strength training and HIIT to boost insulin sensitivity, and even suggests yoga and stretching to manage stress, which plays an underrated role in metabolic health.

Dr. Somani, agrees, citing guidelines from the American Gastroenterological Association. “Focus on natural, unprocessed foods with complex carbs, fibre, and protein,” he says. “Coffee, garlic, broccoli, green tea, walnuts, and foods rich in omega fatty acids like salmon or flaxseeds have shown to benefit the liver.” For exercise, he advises 150–300 minutes of moderate aerobic activity — or 75–150 minutes of more intense workouts — per week.

But what about cultural and regional nuances? Dr Sapra says personalisation matters. “There’s a genetic predisposition in some populations toward insulin resistance,” he explains. “That makes sugar and sedentary habits even more harmful.” He urges residents to lean into local superfoods — like hamour, leafy greens, olive oil, and nuts — and swap sugary beverages with unsweetened Arabic coffee or infused water.

His pro tip for festive months? “Avoid fried indulgences and instead go for grilled meats and hydrating drinks like laban.” Dr Sapra also advocates for consistent, small lifestyle changes, such as replacing juices with whole fruits for better fibre and lower sugar intake. And when it’s too hot to walk outside, “even a brisk walk in the mall counts,” he says. Two resistance training sessions a week? Non-negotiable, especially for those with metabolic risk factors.

Doctors across the UAE are calling out common myths associated with MASLD and urging families to take the condition seriously — even if they feel “perfectly healthy.”

“One of the biggest misconceptions is that only alcoholics or obese people get fatty liver,” says Dr Shareej. “In reality, MASLD affects people of all ages, sizes, and backgrounds — including those who don’t drink and who appear fit.” He highlights that the disease is often misunderstood as rare, harmless, or easily treatable with medication. “It’s not rare. It affects nearly 25 per cent of the global population. And in most cases, lifestyle change — not pills — is the first and best treatment.”

Dr Kannan points out that many people mistakenly believe there’s a magic medication or quick fix. “There are no specific drugs that can melt away liver fat,” he says. “The only proven way to manage and reverse fatty liver is through lifestyle changes — particularly by cutting down on carbs, increasing physical activity, and managing stress.” He adds that even non-smokers and non-drinkers are at risk if they consume excess sugar and avoid exercise.

Another dangerous myth? That fatty liver isn’t serious. “That’s simply not true,” says Dr. Raheem. “If left untreated, it can progress to fibrosis, cirrhosis, liver failure, or even cancer.” He also cautions against using unregulated supplements as a “cure,” warning that some can actually damage the liver further. His advice for UAE families is simple but effective: maintain a balanced diet, stay active, control blood sugar, and get regular health check-ups, especially if you’re in a high-risk category like those with diabetes or obesity.

Dr Somani agrees: “There is no substitute for a healthy diet and regular exercise. Lifestyle changes are not just helpful — they are the cornerstone of fatty liver treatment.”

For Dr Sapra, the problem often starts with misinformation. “People assume if they aren’t overweight, they’re safe — but about one in five people with fatty liver have a normal BMI,” he says. “Also, many think NAFLD is alcohol-related. In reality, it’s more commonly driven by sugar and unhealthy eating.”

He offers practical tips for families to build liver-friendly habits at home. “Make lifestyle changes a family affair,” he says. “Do routine liver screenings, especially if someone is diabetic or overweight. Keep a weighing scale where it’s visible — like outside the bathroom — as a daily nudge to stay aware.”

His go-to advice? Encourage kids to join in healthy cooking, use wholegrains like brown rice, and turn outings into movement — whether it’s swimming or a walk at the beach. “We’ve seen great improvements in patients who follow lifestyle changes consistently, especially when tracked through tools like FibroScan.”

One final misconception is that you’ll know when your liver is struggling. “Fatty liver rarely shows obvious symptoms early on,” Dr. Shareej warns. “Which is why regular check-ups are so important.”

The bottom line? Don’t wait for your liver to scream. Eat well, move often, stay informed — and leave the myths behind. As Dr Jayakumar puts it, “The liver may be silent, but it’s speaking volumes through your lifestyle. Listen now — or risk paying later.”