Fatty liver in Saudi Arabia and the Middle East

1How common it is

Modelled and pooled estimates. Local studies vary with the test used and the group studied.

2Where it is heading

• A Saudi model (2018–2030) predicts people with F0–F3 fibrosis doubling to 2.5 million, and cirrhosis plus liver cancer cases tripling to about 212,000.
• The same model estimated NASH-related costs at about 5.8% of national health spending in 2019.
• In Saudi Arabia, MASLD is rising while hepatitis B is falling and hepatitis C is stable. Fatty liver is becoming the main chronic liver disease.
• Across the region, high fasting blood glucose is the largest risk factor driving the MASLD burden.

3What patients tell us

In a survey of 804 Saudi patients, 79% called their condition "fatty liver" frequently or always, and only 17% had told family or friends about it. Few reported stigma, but 43% had missed or avoided a primary care visit because of their liver disease.

This is why our patient pages say "fatty liver" (الكبد الدهني) first and explain MASLD second.

4The gaps

• Knowledge: in a survey of 584 doctors from Saudi Arabia, Egypt and Türkiye, guideline adherence was 81–84% among specialists but 38–51% among non-specialists.
• Research: from 2014 to 2023, Arab countries produced 844 MASLD papers, about 3.3% of the world total, despite some of the highest prevalence.

Related topics

• MASLD guidelines side by side
• Who to test for liver fibrosis
• The two-step fibrosis pathway

References

1. Younossi ZM, et al. Prevalence of MASLD in the Middle East and North Africa. Liver Int 2024;44(4):1061–70. doi:10.1111/liv.15852
2. Alqahtani SA, et al. The burden of MASLD and viral hepatitis in Saudi Arabia. Saudi J Gastroenterol 2024;30(5):310–8. doi:10.4103/sjg.sjg_62_24
3. Sanai FM, et al. Clinical and economic burden of NASH in Saudi Arabia, United Arab Emirates and Kuwait. Hepatol Int 2021;15(4):912–21. doi:10.1007/s12072-021-10182-x
4. Sarkoohi Z, et al. Epidemiological trends and burden of MASLD in the Middle East and North Africa region: a 32-year analysis. J Health Popul Nutr 2025;44(1):207. doi:10.1186/s41043-025-00973-5
5. Alqahtani SA, et al. Stigma in steatotic liver disease: a survey of patients from Saudi Arabia. Saudi J Gastroenterol 2024;30(5):335–41. doi:10.4103/sjg.sjg_122_24
6. Alqahtani SA, et al. Knowledge about MASLD among medical professionals from countries in the MENA region. Ann Hepatol 2025;30(1):101569. doi:10.1016/j.aohep.2024.101569
7. Alhazzani W, et al. A bibliometric analysis of a decade's research on MASLD in the Arab world. Saudi J Gastroenterol 2025;31(3):157–67. doi:10.4103/sjg.sjg_431_24
8. Abaalkhail F, et al. MASLD management in Saudi Arabia: a modified Delphi-based adaptation of international standards. Saudi J Gastroenterol 2026;32(2):104–20. doi:10.4103/sjg.sjg_199_25

A summary of published guidelines for healthcare professionals. It does not replace clinical judgement, the full guidelines or local drug labels. Disclaimer.