Fatty Liver: 58% of People With Diabetes in Saudi Arabia Have It — and Most Don't Know

A disease with almost no symptoms, discovered by chance in a blood test or scan — and our region leads the world in it. It's time to talk about it.

The numbers

A systematic review and meta-analysis on Saudi Arabia found pooled prevalence of non-alcoholic fatty liver disease among adults at 16.8% (11.1–22.5%), rising among people with type 2 diabetes to 58.0% (45.0–70.9%)^[1],[2]. Regionally, prevalence in the Middle East is estimated at 32% — the highest globally versus about 25% worldwide^[3].

And the trend is rising

Projections indicate fatty liver cases in Saudi Arabia rising from 8.45 million in 2017 to 12.53 million by 2030, with an expected prevalence of 31.7%^[4].

Why does it matter?

Because it is silent until advanced. And it is closely linked to obesity, diabetes and insulin resistance — all three highly prevalent here (obesity · diabetes).

The excellent news: its treatment is primarily dietary

• Weight loss is the first treatment: even a modest amount clearly improves liver fat.
• Free sugars and sweetened drinks are the first thing to cut (the six-spoon limit).
• Ultra-processed food: reduce it (why).
• Movement works even without weight loss: physical activity improves liver fat in its own right.