For many years doctors have told me that the best treatment for NAFLD/NASH (now referred to medically as MAFLD/MASH) was simply losing weight. That’s because we did not have any pharmaceutical treatments (until ezdiffra (resmetirom) from Madrigal in 2024), and until late stage fibrosis & cirrhosis develops, most liver disease is fully reversible.
On August 15, 2025, the FDA granted accelerated approval to Wegovy (semaglutide 2.4 mg) for treating adults with non-cirrhotic MASH and moderate to advanced liver fibrosis. This is an enormous milestone in the treatment of this disease. This makes Wegovy the first GLP‑1 receptor agonist to earn that distinction, and only the second overall drug to treat MASH.
GLP-1 drugs have obviously been all the rage for weight loss, and there has been some off-label use of them to treat liver disease like MASH, but in the Phase III ESSENCE trial, after 72 weeks, 63% of patients on Wegovy saw their steatohepatitis resolved without any worsening of fibrosis, compared to just 34% with placebo. And 37% saw an improvement in fibrosis with no worsening of inflammation, versus 22% in the placebo group. So it is not just helping patients lose weight but showing meaningful improvement for liver disease.
Dr. Martin Holst Lange, Novo Nordisk’s Chief Scientific Officer, put it bluntly: “Wegovy is now uniquely positioned as the first and only GLP‑1 treatment approved for MASH, complementing the already proven weight loss, cardiovascular benefits and extensive body of evidence linked to semaglutide”
Living with liver disease will still require lifestyle changes; these are foundational to the process. But now, there’s medicine that can resolve inflammation and heal fibrosis, beyond just nudging the scale downward. A tremendous step forward!
NASH AWARE 