New study links weight loss drugs to better liver health outcomes

A new review highlights how anti-obesity drugs like semaglutide and tirzepatide may help reverse fat build-up, inflammation, and scarring in patients with MASLD and MASH

  A new research published in the World Journal of Gastroenterology suggests that some weight loss medications could do more than just help people shed kilos - they may also improve liver health. 

The study, titled ‘Efficacy and Safety of Anti-Obesity Drugs in Metabolic Dysfunction-Associated Steatotic Liver Disease: An Updated Review’, found that in people with metabolic dysfunction-associated steatotic liver disease (MASLD) and its more serious form, metabolic dysfunction-associated steatohepatitis (MASH), drugs originally developed to treat obesity and diabetes are showing promising benefits for the liver.

 

Understanding MASLD and MASH 

MASLD (metabolic dysfunction-associated steatotic liver disease) refers to excess fat accumulation in the liver (fatty liver) driven by metabolic dysfunction (for example, obesity, insulin resistance). It is one of the most prevalent chronic liver diseases worldwide, affecting nearly 30 per cent of the adult population. 

 

MASH (metabolic dysfunction-associated steatohepatitis) is a more progressive form of MASLD, involving inflammation and damage to liver cells (steatohepatitis), with the potential to lead to fibrosis (scarring) and cirrhosis.

 

Traditionally, the cornerstone of MASLD and MASH management has been lifestyle change, weight loss by diet and exercise, sometimes supported by off-label medications or surgical approaches. The challenge has been finding therapies that can reliably reverse liver damage while being safe and well tolerated in the long term.

 

What the new evidence shows

 

• The Liraglutide Efficacy and Action in NASH (nonalcoholic steatohepatitis) trial found that after 48 weeks, many patients showed improved liver health, with several achieving disease resolution and no worsening of scarring. The drug also helped improve liver tissue and reduce key liver damage markers.
• In MASLD, semaglutide helps by reducing fat buildup in the liver, improving how the body uses insulin, and lowering liver inflammation. Clinical trials have shown that it can also reverse liver inflammation (steatohepatitis) and reduce liver scarring (fibrosis).
• Tirzepatide, which works on both GLP-1 and GIP receptors, has shown impressive results. It helps reduce fat in the liver and around internal organs, while slightly increasing healthier fat just under the skin. This suggests the drug not only supports weight loss but also improves overall fat distribution in the body. GLP-1 (Glucagon-Like Peptide-1) and GIP (Glucose-Dependent Insulinotropic Polypeptide) receptors are proteins in the body that help regulate blood sugar, appetite, and fat metabolism.
• Retatrutide is a new drug that targets three receptors - GLP-1, GIP, and glucagon, to improve metabolism and aid weight loss. Early studies show it can reduce liver fat and help people lose over 24 per cent of their body weight, though its effects on liver scarring and long-term safety still need more research.

 

Also read:  Fatty liver to liver cancer: Risks, habits, and how to protect yourself

 

Limitations and challenges

• Most trials are relatively short (6–12 months). Long-term safety, durability, and whether benefits persist or regress are not fully known yet.
• Many trials rely on surrogate endpoints (MRI-based measures, biochemical markers) rather than repeated liver biopsies.
• Some patients discontinue therapy because of tolerability issues or cost and coverage limitations. In semaglutide trials, about 20–30 per cent discontinued GLP-1 therapy.
• Patient heterogeneity (genetics, stage of liver disease, comorbidities) means not all will respond equally. Identifying predictors of response remains a research priority.

 

Researchers emphasise that while these new treatments are a major step forward in managing MASLD, access remains a global challenge. High drug prices and limited insurance coverage continue to make these therapies out of reach in many low- and middle-income countries, regions where obesity and MASLD are often most common.  The team called for fair pricing models and the inclusion of high-risk patients in public health programmes to ensure treatment benefits reach those who need them most.

 

Implications for clinical care

These advances signal a potential shift in how liver disease linked to metabolic dysfunction is managed. Rather than being treated only via lifestyle or surgery, pharmacotherapy (medical treatment by means of drugs) may play an increasing role, particularly in patients with moderate to advanced disease who have not responded well to non-drug measures.

 

Nonetheless, experts emphasise that weight loss and lifestyle modification remain foundational. These medications are likely best used as adjuncts, not substitutes, to diet, exercise, and metabolic risk control. Combination therapy is also a possibility, for instance pairing an incretin agent with a liver-targeted drug, to optimise outcomes.

 

 

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This report is for informational purposes only and is not a substitute for professional medical advice.