ABU DHABI // Obese people know they are at greater risk of heart attacks and strokes - but awareness of an equally deadly condition is rare.
Health experts are now highlighting the dangers of non-alcoholic fatty liver disease, which they say the public knows little about.
"They have some idea that if they are obese it might affect the liver but they don't have an exact idea of how serious the disease can be," said Dr Huda Kattaa, a consultant gastroenterologist at the American European Medical Centre in Abu Dhabi.
"People need to be more aware. Simply changing the lifestyle might prevent all the complications of the disease. Sustained, gradual weight loss and exercise is the hallmark of treatment of fatty liver disease."
Left untreated, a fatty liver can progress to cirrhosis, liver failure or even cancer of the liver.
If caught early enough, Dr Kattaa said the illness could be treated.
"People who have a simple fatty liver, if they start to lose weight and exercise they have a very good prognosis," she said. "Those who don't, especially a certain group who are genetically predisposed, might develop a more aggressive disease."
There are no figures for the prevalence of the condition in the UAE, but Dr Kattaa believes it is high. "There is a high level of obesity and diabetes in the UAE and these are two of the main risk factors," she said.
A third is metabolic syndrome - when people carry too much weight around their waists and have high blood pressure and a high lipid count in their blood.
"Obesity is a growing problem in the UAE and we expect the number of people with fatty liver disease to go up if patients do not adopt a healthier lifestyle," Dr Kattaa said.
World Health Organisation statistics suggest 20 to 30 per cent of people in the Middle East are affected.
"We have figures worldwide that the rate of fatty liver disease has doubled over the past 20 years, especially in Western countries it has become the number one liver disease," Dr Kattaa said.
Many patients have no symptoms, while others can experience fatigue or discomfort. For most people it is picked up when they have an ultrasound or are referred for further exploration after a mild abnormality in a liver-function test, she said.
Prof Hassan Abou-Rebyeh, who works at Abu Dhabi's Burjeel Hospital, said he had seen obese children with the condition in Abu Dhabi.
"It's worrying because fatty liver disease has the risk to ... damage the liver and maybe lead to liver failure and liver cancer," he said.
"When you start early, like in child-hood, and are not able to correct it maybe in the time frame of 10 to 20 years, you might have damaged the liver, then you are one of the young patients with chronic liver failure."
Consultant hepatologist Dr Ali Elsayed has worked in the UAE since 1996 and said an increasing number of people have the condition, blaming this on the sedentary lifestyle.
"There's no exercise and too much junk food," said Dr Elsayed, who works at the Khalifa Street branch of Al Noor Hospital in Abu Dhabi.
Most sufferers are obese, diabetic or have high cholesterol but about 30 per cent do not have any of these risk factors and there is no obvious cause for the illness, he said.
Dr Jamil Akhras, a gastroenterologist and hepatologist at Dubai's Mediclinic City Hospital, believes the number of sufferers is increasing because doctors are more aware of the disease, as well as the growing diabetes and obesity problem.
"The main problem we still have is there is no medicine we can give to cure the problem, Dr Akhras said. "The only effective treatment so far is weight loss and controlling other conditions, like diabetes."