Fatty Liver Disease: Symptoms, Causes and Your Genetic Risk
One of the most common — and most under-diagnosed — metabolic conditions in India, often found only during a routine blood test or ultrasound. Here's how to recognise it, what drives it, and what to do next.
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Recognising It
Symptoms of fatty liver
In its early stage, fatty liver often causes no symptoms at all. When signs do appear, they tend to be subtle and easy to miss:
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Persistent fatigue or low energy
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A dull ache or discomfort in the upper right abdomen
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A feeling of fullness or bloating
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Mildly enlarged liver, detectable on exam or scan
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Elevated liver enzymes found incidentally on routine blood tests
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Advanced stages: jaundice, leg/abdominal swelling, unexplained weight loss
Most cases are picked up through routine liver function tests or imaging rather than symptoms. This list is educational only and does not replace clinical diagnosis.
The Drivers
What causes it?
Genetic factors
Not everyone who is overweight develops fatty liver, and some people of normal weight do — a strong sign that genetics affects how bodies process and store fat. unlock.fit's CoGsI research identified several genes tied to fat-metabolism pathways relevant to fatty liver risk:
SULT1C4[2]
A sulfotransferase gene; research has found increased protein expression of this gene in people with fatty liver and obesity. It was significantly associated with T2D risk in unlock.fit's own CoGsI study (rs1402467, OR 2.04, 95% CI 1.64–2.53)[1].
PPARG[3]
Influences how the body stores fat versus burns it for energy; variants here have been linked to more advanced NAFLD in population studies.
Triglyceride & cholesterol transport variants
Influence how efficiently fat is cleared from the liver versus stored in it.
Lifestyle & environmental factors
Alongside genetic risk, day-to-day habits play a major role in how much fat accumulates in the liver:
- A diet high in added sugar, refined carbohydrates and fried or processed food
- Excess body weight, particularly abdominal fat
- Insulin resistance, often present before a formal diabetes diagnosis
- Sedentary lifestyle with little physical activity
- Very rapid weight loss, which can paradoxically raise liver fat short-term
- Certain medications, and rapid diet changes made without medical supervision
Our Approach
How unlock.fit's DNA + blood approach helps
Our blood panel includes liver-relevant biomarkers alongside a DNA test that reads fat-metabolism genes such as SULT1C4 and PPARG — helping identify whether elevated liver fat is driven more by diet and lifestyle, an underlying genetic tendency, or both.
DNA + blood testing
Reads fat-metabolism genes and liver-relevant blood biomarkers to separate genetic tendency from lifestyle driver.
A plan built for your liver, not a generic diet
Our dietitians build a plan that specifically targets liver fat reduction — typically lower in added sugar and refined carbohydrate, higher in fibre and protein.
Frequently asked questions
Yes, in many cases. Early-stage fatty liver (before significant scarring occurs) can often be improved or reversed through sustained dietary changes, weight management and increased physical activity.
No. Non-alcoholic fatty liver disease (NAFLD) occurs in people who drink little or no alcohol and is primarily linked to diet, obesity, insulin resistance and genetic factors affecting fat metabolism.
Yes. This is sometimes called "lean NAFLD." Genetic factors affecting fat metabolism mean some people of normal weight or BMI can still accumulate excess fat in the liver.
Generally, added sugar, refined carbohydrates, fried food and excess alcohol are advised against. Specific recommendations should be personalised based on individual bloodwork and, where available, genetic risk factors.
Understand your own fatty liver risk
A DNA + blood panel won't diagnose fatty liver on its own — but paired with your doctor's imaging and liver function tests, it shows whether genetics is part of the picture, so your nutrition plan can target the real driver.