Rising Rates of Fatty Liver Disease Highlight the Hidden Impact of Diabetes and Obesity

A new UK study has highlighted a growing public health concern: metabolic dysfunction-associated steatotic liver disease, or MASLD, is being diagnosed far more often than it was a decade ago. The condition is closely associated with obesity, type 2 diabetes and other metabolic health problems, yet researchers say many cases may still be going undetected.

The research, involving almost 12 million people in UK general practice records between 2003 and 2022, found a substantial rise in recorded MASLD diagnoses. In 2003, only around 0.02 per cent of adults in the dataset had a recorded diagnosis, equivalent to approximately 1,300 people. By 2022, that figure had risen to 2.4 per cent, representing about 283,762 people.

Although the increase partly reflects greater awareness and improvements in diagnosis, researchers say the figures also point to a much larger underlying problem.

What is MASLD?

MASLD is a condition in which excess fat accumulates in the liver in association with metabolic risk factors. It was previously known as non-alcoholic fatty liver disease.

The condition can range from relatively mild liver fat accumulation to more serious disease involving inflammation, scarring and, in some cases, advanced liver damage.

One of the difficulties is that people can have MASLD without obvious symptoms. When symptoms do occur, they can include tiredness, abdominal discomfort and a general feeling of being unwell. This means that the condition may remain unnoticed until a person undergoes blood tests, scans or investigations for another health problem.

The new study suggests that this lack of obvious symptoms may be contributing to a significant diagnostic gap.

Diabetes and obesity are important risk factors

The research found that people diagnosed with MASLD were three times as likely to have type 2 diabetes. The findings also point to increased risk among people who are overweight or inactive, those aged over 50 and people with high blood pressure.

This relationship is important because diabetes and obesity are already major health concerns in the UK.

The study's findings arrive as NHS data show that 30 per cent of adults aged 16 and over were living with obesity in 2024. It is also estimated that almost six million people in the UK are living with diabetes, including a substantial number who may have undiagnosed type 2 diabetes.

These conditions can occur together because they share several underlying metabolic risk factors. Excess body fat, insulin resistance, high blood pressure and abnormal blood lipid levels can all contribute to poorer metabolic health.

The liver is an important part of this system. When excess fat accumulates in liver cells, it can eventually contribute to inflammation and scarring in some people.

Diagnosis may still be missing many cases

Despite the sharp increase in recorded MASLD diagnoses, researchers argue that the number of identified cases remains well below estimates of how common the disease is expected to be.

The study therefore suggests that the UK's recorded prevalence of 2.42 per cent in 2022 represents only part of the picture.

This matters because identifying liver disease earlier can give healthcare professionals an opportunity to assess a person's risk and address related metabolic conditions.

The researchers highlighted blood-based tools that can help estimate the likelihood of liver scarring. Such assessments may help identify people who require further investigation, particularly those already known to have conditions such as type 2 diabetes or obesity.

The researchers say more active case-finding among higher-risk groups could help narrow the diagnostic gap.

Ethnic inequalities also require attention

The study identified another important issue. People of South Asian ethnicity were overrepresented among those diagnosed with MASLD. However, they were less likely to have a liver fibrosis score recorded, despite having higher levels of type 2 diabetes.

This raises concerns about whether some groups are receiving appropriate assessment for liver complications.

The researchers said further work is needed to understand and reduce potential health inequalities. They also warned that disparities could become increasingly important as new medicines and treatments are developed for metabolic liver disease.

Addressing these differences will require more than simply increasing the number of diagnoses. Healthcare systems also need to ensure that people at higher risk have equitable access to assessment, monitoring and treatment.

What can people do?

The findings do not mean that everyone with obesity or diabetes will develop serious liver disease. Risk varies between individuals, and having a risk factor does not guarantee that someone will develop MASLD.

However, the study reinforces the importance of looking after overall metabolic health.

For people with type 2 diabetes, high blood pressure or concerns about their weight, speaking with a GP or other healthcare professional can be a useful starting point. Clinicians can assess individual risk and determine whether blood tests or other investigations are appropriate.

Lifestyle measures can also play an important role in metabolic health. Regular physical activity, a balanced diet, maintaining a healthy weight where appropriate, and following medical advice for conditions such as diabetes and high blood pressure can all contribute to better health.

People should not rely on symptoms alone to determine whether their liver is healthy, because MASLD can be present without noticeable warning signs.

A growing health challenge

The rise in recorded MASLD diagnoses reflects a broader change in the UK's health landscape. As obesity and type 2 diabetes become increasingly common, conditions associated with metabolic health are also receiving greater attention.

The new research suggests that the healthcare system has become better at recognising MASLD, but that recognition has not yet caught up with the likely scale of the disease.

Earlier identification could be particularly valuable for people who already have several risk factors. Detecting liver problems before significant scarring develops may give patients and healthcare professionals more opportunities to manage contributing conditions and reduce future complications.

The study therefore presents MASLD as more than an isolated liver problem. Its close links with diabetes, obesity and cardiovascular risk demonstrate why metabolic health needs to be considered as a whole.

With hundreds of thousands of cases now recorded and potentially millions more remaining undiagnosed, researchers say closing the diagnostic gap should be a public health priority.

Source

The Independent, report published 27 August 2026, based on research by Queen Mary University of London and the University of Glasgow using UK general practice records covering almost 12 million people between 2003 and 2022.

Disclaimer

This article is for general informational purposes only and is not medical advice. The presence of a risk factor does not mean that an individual has MASLD or will develop liver disease. Anyone concerned about diabetes, obesity, liver health or related symptoms should speak with a qualified healthcare professional. Figures and study findings should be interpreted in the context of the original research and available NHS data.