Ultrasound showed grade II fatty liver.

Your ultrasound shows Grade II fatty liver, which means a moderate amount of fat has accumulated in your liver. The good news is that fatty liver is often reversible, particularly when detected before significant liver fibrosis develops. Even though you do not consume alcohol, smoke, or eat much junk food, fatty liver can develop due to insulin resistance, abdominal obesity, high triglycerides, diabetes, or genetic factors. My recommendations: 1. Exercise: You are already following a good exercise routine. Continue cycling and walking, but gradually increase your activity to at least 150–300 minutes per week. Include strength-training exercises twice weekly. 2. Weight management: If you are overweight, aim to reduce approximately 5–10% of your body weight gradually. Even a 5% reduction can improve liver fat accumulation. 3. Diet: Reduce refined carbohydrates, sweets, sugary beverages, white bread, and excess saturated fats. Include more vegetables, fruits, whole grains, pulses, and adequate protein. 4. Avoid alcohol: Continue avoiding alcohol completely. 5. Investigations: I recommend checking your liver function tests (LFT), complete lipid profile, fasting blood sugar or HbA1c, and complete blood count with platelet count. 6. Fibrosis assessment: At your age, it is important to assess whether there is any liver fibrosis. This can initially be evaluated using the FIB-4 score, calculated from your age, AST, ALT, and platelet count. A FibroScan may be recommended depending on your risk factors and results. 7. Follow-up: Repeat your liver investigations as advised by your treating doctor, commonly after approximately 3–6 months of lifestyle modification. Can Grade II fatty liver completely recover? Yes, liver fat can decrease substantially and sometimes return to normal with sustained lifestyle changes. However, recovery depends on the underlying cause and whether fibrosis is present. There is no need to panic, but fatty liver should not be ignored simply because you have no symptoms. I would like to know a few additional details: 1. What is your current height and weight? 2. Do you have diabetes, hypertension, or high cholesterol? 3. Are your liver enzymes (SGOT/SGPT) normal? 4. Do you have increased abdominal fat or a family history of fatty liver? Please share your ultrasound report and recent blood investigations for a more specific assessment.