Semaglutide shows powerful benefits for liver disease beyond weight loss
11 November 2025
For many people with metabolic dysfunction-associated steatohepatitis (MASH), losing weight can help slow or even reverse liver damage. But new research suggests that weight loss isn’t the whole story.
A secondary analysis of the large phase III ESSENCE trial, presented by Professor Philip Newsome at this week's American Association for the Study of Liver Diseases (AASLD) meeting, has shown that semaglutide – the weight loss medication widely known as Ozempic or Wegovy – may also protect the liver through direct biological effects, independent of weight loss.
A closer look at the data
The study evaluated 800 participants with biopsy-confirmed MASH who received either weekly semaglutide injections or placebo for 72 weeks.
Incredibly, patients taking semaglutide were nearly four times as likely to recover from MASH without worsening liver scarring compared to those on placebo. And even more strikingly, those benefits appeared both in patients who lost significant weight and in those who didn’t.
“People receiving semaglutide, even at lower levels of weight loss, are achieving significant rates of improvement across a whole range of MASH parameters”
– Professor Philip Newsome, Director of the Roger Williams Institute of Liver Studies and Chief Investigator of the ESSENCE trial
More than a weight loss drug
The findings reveal twin benefits. Around half of semaglutide’s positive effect was explained by weight loss, while the other half appeared to stem from direct anti-inflammatory and metabolic actions in the liver itself.
That means even modest changes on the scales could translate to meaningful improvements in liver health – a reassuring message for patients who struggle to achieve large amounts of weight loss.
For fibrosis (liver scarring), semaglutide also doubled the odds of improvement without worsening inflammation, compared to taking a placebo. A similar pattern was seen in scans measuring liver stiffness.
A new era for MASH treatment
MASH – previously known as NASH – is one of the most common and fastest-growing causes of chronic liver disease worldwide. It affects an estimated 6% of adults and over 30% of people with obesity or diabetes. Left untreated, it can lead to cirrhosis, cancer or needing a liver transplant.
Until recently, the only way to treat MASH was through lifestyle changes such as diet, exercise and weight loss. Now, semaglutide has become the first US-approved medicine shown to directly improve the condition – a major step forward for patients around the world.
“These findings are hugely encouraging,” said Professor Newsome. “They suggest semaglutide can benefit the liver through multiple pathways, not just through weight loss. That gives patients and clinicians a real sense of optimism.”
Looking ahead
Further research will explore how these weight-independent effects work at a cellular level – and whether similar benefits can be seen across different forms of what is sometimes known as fatty liver disease.
For now though, the message is clear: semaglutide is helping rewrite what’s possible for patients with MASH, bringing new hope for a condition that until recently had no approved medical treatment.
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