Doctors are increasingly emphasizing that fatty liver disease is primarily a metabolic condition, rather than solely an alcohol-related problem. This understanding marks a significant shift in medical consensus, with the condition previously known as Non-Alcoholic Fatty Liver Disease (NAFLD) now officially termed Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Leading hepatologists, including Dr. Cyriac Abby Philips, known as TheLiverDoc, have highlighted that MASLD is the most common chronic liver disease globally, affecting a staggering 30-40% of the general adult population, 60-70% of those with type 2 diabetes, and 70-80% of individuals with obesity. MASLD is driven by underlying metabolic dysfunctions such as insulin resistance, visceral fat accumulation, and high blood sugar, rather than alcohol consumption. This explains why many individuals who do not drink alcohol are still diagnosed with fatty liver. Dr. Daksh Sethi, a Bariatric and Laparoscopic Surgeon, notes that MASLD is essentially the liver's manifestation of metabolic syndrome. In India, the risk is further heightened by the 'thin-fat' phenotype, where individuals may appear lean but carry excess internal fat, coupled with diets high in refined carbohydrates and sedentary lifestyles, leading to insulin resistance. If left unaddressed, MASLD can progress from simple fatty liver to Metabolic Dysfunction-Associated Steatohepatitis (MASH), fibrosis, cirrhosis, and even liver cancer. Crucially, cardiovascular disease, not liver failure, is the leading cause of death in MASLD patients, underscoring the necessity for early metabolic control. Medical evidence strongly supports that weight loss, dietary modifications, and regular physical activity are the most effective treatments, while unproven supplements offer no long-term benefit. India has witnessed a significant increase in MASLD prevalence, making early detection and lifestyle interventions critical for public health.