Deadly liver disease is now striking non-drinkers in record numbers - most don't know they have it

Liver disease is surging globally and could affect nearly 1.8 billion people by 2050, research suggests.

Once thought to be a condition that mainly affected heavy drinkers, cases in people who rarely or never drink alcohol have soared in recent decades.

This form – now known as metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease – is driven instead by obesity, type 2 diabetes and high blood pressure.

It often develops silently, with no symptoms for years, meaning many people have no idea they are living with it until significant liver damage has already occurred.

Left unchecked, fat builds up in the liver, triggering inflammation and scarring over time.

In some cases, this can progress to cirrhosis – where healthy tissue is replaced by permanent scar tissue – as well as liver failure and even liver cancer.

Crucially, MASLD is also considered the liver manifestation of metabolic syndrome – a cluster of conditions including excess body fat, high blood pressure and poor blood sugar control – which significantly raises the risk of heart attacks and strokes.

A major analysis from the Global Burden of Disease study, published in The Lancet Gastroenterology & Hepatology, estimates 1.3 billion people were living with MASLD in 2023 – a 143 per cent increase since 1990.

That figure is expected to rise to around 1.8 billion in the next 25 years, making it one of the fastest-growing health problems worldwide.

The surge is being driven largely by rising obesity, worsening blood sugar control and increasingly sedentary lifestyles.

Some regions are particularly hard hit, with North Africa and the Middle East recording rates well above the global average.

While more cases are now being diagnosed, the overall health impact has remained relatively stable – something researchers believe may reflect earlier detection and improved management slowing progression to more severe disease.

However, experts warn the long-term risks remain serious.

If left undetected and unmanaged, MASLD can progress to cirrhosis, liver failure and liver cancer.

The study also highlights a worrying shift, with more younger adults now developing the condition – particularly in low- and middle-income countries where diets and lifestyles are changing rapidly.

Researchers say the findings underline the urgent need for stronger prevention, earlier diagnosis and greater public health action to curb the growing global burden of fatty liver disease.

The news comes as weight-loss medications such as Mounjaro (tirzepatide) are showing promising results in the treatment of MASLD.

Studies suggest these drugs can significantly reduce liver fat and improve inflammation and in some cases may be associated with improvement in liver scarring in early disease.

By supporting substantial weight loss and better blood sugar control, they may help slow or potentially reverse disease progression, although they are not yet widely approved for this use in the UK.

What is fatty liver disease?

MASLD, NAFLD and fatty liver disease are different names for the same condition.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a long-lasting liver condition caused by having too much fat in the liver.

It is closely linked with being overweight as well as conditions such as type 2 diabetes and heart and circulatory disease.

Metabolic dysfunction-associated steatohepatitis (MASH, previously called NASH) is a more serious stage of MASLD.

In a small number of people it can lead to liver cancer or liver failure.

The main treatment is eating a well-balanced diet, being physically active and (if needed) losing weight.

Research shows these can reduce liver fat and in some cases reverse MASLD.