Fatty Liver
Fatty liver is common and usually silent. Your report needs two questions answered, not one: how much fat, and how much scarring, because they are not the same thing.
Medically reviewed by the RIIMS medical team · Last updated: June 2026
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- Yellow eyes or skin (jaundice)
- Swelling in the abdomen or legs
- Vomiting blood, or black tarry stools
- Confusion or unusual drowsiness
What does a fatty liver report actually mean?
Fatty liver means fat has built up inside liver cells, and it is very common: a 2022 systematic review pooled data across India and estimated that 38.6% of Indian adults have some degree of it. An ultrasound report grades the fat as mild, moderate or severe, Grade 1 to Grade 3, but that grade measures fat only, not scarring. A Grade 3 report with no fibrosis is actually less worrying than a Grade 1 report with significant fibrosis, so the grade by itself does not tell you how serious things are; your doctor needs a separate look at fibrosis risk. Many Indians develop fatty liver well below a BMI of 25, because fat stored around the internal organs matters more here than total body weight. If someone has told you "you are not fat, so it cannot be your liver," that reasoning does not hold in the Indian population; your waist size is usually a better clue than the number on the scale. There is one more nuance that matters. In one study, patients who lost 10% or more of their body weight saw NASH, the inflamed form of fatty liver, resolve completely in 90% of cases. But the underlying scarring, fibrosis, regressed in only 45% of them, and only about 10% of patients in the study managed to lose that much weight in the first place. Once fibrosis has progressed to cirrhosis, weight loss does not undo it. What surprises most patients is that fatty liver works mainly as a marker of metabolic risk: the leading cause of death in people with fatty liver is heart disease, not liver disease.
Symptoms to watch for
- Often no symptoms at all
- Mild tiredness or a dull ache under the right ribs
- Found incidentally on a routine ultrasound
- A normal weight does not rule it out, especially with a large waist
- Raised SGPT or SGOT on a blood report
- Symptoms usually appear only once cirrhosis has developed
When to consult a doctor
See a doctor if fatty liver is found on a scan, even if you feel completely well, so your fibrosis risk can be checked properly. Do not wait for symptoms; by the time they appear, the liver may already be more affected.