Obesity in Indonesia Reaches 23.4%, Beware Its Impact on Fatty Liver Disease
Fatty liver disease is a health condition that often goes unnoticed because it can develop without symptoms in its early stages. This year, Global Fatty Liver Day carries the theme ‘Act Now’, a global call emphasising the urgency of taking concrete action to diagnose and manage fatty liver disease early, given that the condition is often reversible if addressed in time.
Global Fatty Liver Day is initiated by the Global Liver Institute and observed annually on the second Thursday of June to raise awareness of fatty liver disease, a health issue that remains frequently overlooked.
Rino Alvani Gani, an internal medicine specialist and consultant in gastroenterology and hepatology at the Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, explained that fatty liver disease occurs when there is an excessive accumulation of fat in the liver. When associated with metabolic disorders, the condition is known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).
Rino explained that MASLD generally does not cause symptoms in its early stages, meaning many cases go undetected. ‘This disease is a spectrum; in the early stages, it may only involve fat accumulation. However, if risk factors are not managed, some patients can develop inflammation and cell damage. In the long term, this increases the risk of fibrosis, cirrhosis, and even liver cancer,’ he said during an educational discussion for Global Fatty Liver Day 2026 in Jakarta on Thursday (11/6).
Rino added that MASLD must also be viewed as part of a broader cardiometabolic risk, as cardiovascular disease is the leading cause of death among patients with MASLD. ‘Therefore, early detection and comprehensive management of risk factors are crucial,’ he stated.
He further noted that individuals living with obesity, central obesity, type 2 diabetes, or abnormal liver function test results need to be vigilant about this condition and consult healthcare professionals for risk assessment and early liver health detection. In Indonesia, the management of fatty liver disease must be based on a doctor’s assessment and the individual patient’s condition. Managing risk factors, including body weight and metabolic disorders, is a key part of efforts to reduce the risk of disease progression.
‘Because obesity is one of the upstream factors, weight management is an important part of the prevention and management approach to metabolic risk,’ Rino said.
Obesity, a Major Trigger
Director of Non-Communicable Diseases at the Ministry of Health, Siti Nadia Tarmizi, who also spoke at the event, stated that obesity has become a serious health challenge in the country. As the prevalence of obesity increases, the risk of fatty liver disease and other chronic illnesses also rises.
Obesity, she noted, is even known as the ‘mother of all chronic diseases’ because it can trigger various health complications. ‘Therefore, we urge the public to be more aware of their risk factors and to undergo early detection to maintain liver health. Act now before the condition progresses further,’ she said.
Siti Nadia emphasised that obesity is a major driver of this condition because it can cause metabolic disorders and fat accumulation in various organs, including the liver. Hence, obesity must be addressed to prevent it from causing or worsening MASLD. In some patients, MASLD can progress to Metabolic Dysfunction-Associated Steatohepatitis (MASH), a more severe form involving inflammation and liver cell damage, which in the long term can increase the risk of fibrosis, cirrhosis, and liver cancer.
Based on the 2023 Indonesian Health Survey, the prevalence of obesity among adults aged over 18 reached 23.4%, while central obesity among the population aged 15 and above reached 36.8%. These figures underscore the need for collective attention to obesity as an upstream factor for various chronic diseases, including fatty liver disease.
Central obesity, often referred to as a pot belly or apple-shaped obesity, is a condition of excess fat accumulation concentrated in the abdominal area. This fat is not only located under the skin but also envelops vital internal organs (visceral fat). This condition is far more dangerous than generalised excess weight because it directly triggers the release of inflammatory substances and disrupts the body’s metabolism.
Dicky Levenus Tahapary, an internal medicine specialist and consultant in endocrinology, metabolism, and diabetes at the Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, stressed that obesity must be understood as a chronic medical condition requiring comprehensive management. ‘Obesity is a complex medical condition and cannot be simplified as merely a matter of willpower. Excess body fat, especially visceral fat, can trigger insulin resistance, inflammation, and metabolic disorders that impact various organs, including the liver, heart, and blood vessels,’ he said.
Therefore, the goal of obesity management is not just to reduce body weight, but also to support quality weight loss and long-term metabolic health. When pharmacological therapy is considered, including GLP-1-based therapies, the choice of treatment must be based on the patient’s condition and clinical evidence. Not all GLP-1-based therapies have the same efficacy and safety profile.