Semaglutide: A New Hope for Liver Health in 2025

In 2025, a significant update was made to how doctors treat a liver condition called MASH (Metabolic Associated Steatohepatitis). This condition, previously known as NAFLD (Non-Alcoholic Fatty Liver Disease), is linked to metabolic issues.

The Drug: Semaglutide (Wegovy)

The FDA gave Wegovy the green light in August 2025 for treating MASH with moderate to advanced fibrosis. This decision was based on the ESSENCE study, which showed promising results:

62.9% of patients had resolution of MASH without worsening of fibrosis, compared to 34.3% on a placebo.
36.8% of patients had a reduction in liver fibrosis without worsening of MASH, compared to 22.4% on a placebo.

Treatment Guidelines

Doctors now have guidelines on who should get this treatment. Patients with MASH and stage 2-3 fibrosis are good candidates. Non-invasive tests like VCTE, MRE, or ELF can be used to check the liver's condition instead of a biopsy. For patients with more advanced fibrosis, doctors need to be careful and make individualized decisions.

Safety and Side Effects

Semaglutide is generally safe, but patients might experience some side effects like:

Nausea
Diarrhea
Constipation

These side effects are usually mild and temporary. Doctors should also watch out for rare but serious risks like:

Kidney injury
Gallbladder disease
Pancreatitis

Lifestyle Changes

Lifestyle changes are still very important in managing MASH. While semaglutide can help, patients should also focus on diet and exercise. Doctors can use non-invasive tests to monitor how well the treatment is working. If the liver enzymes or tests show worsening, it might mean the treatment isn't working well.

Conclusion

In summary, semaglutide offers a new and promising treatment option for MASH. With proper monitoring and lifestyle changes, it can significantly improve liver health.