Twenty-three of 26 adults with obesity who entered a Wegovy trial with excess fat in their livers had normal liver fat levels by week 72, Novo Nordisk said in a press release on its semaglutide liver fat analysis issued Oct. 1. The findings were presented at the European Association for the Study of Diabetes (EASD) Annual Meeting 2026 in Milan, Italy.
That works out to 88.5%, the "9 out of 10" figure in Novo's headline. But it comes from a small subgroup of a much larger trial program, and Novo describes the work as a post hoc, exploratory analysis that was not a pre-specified primary or secondary goal of the trials.
The finding touches on a common and often silent problem. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that about 24% of U.S. adults have nonalcoholic fatty liver disease, including more than 90% of people with severe obesity.
Small Numbers Behind the 88.5% Figure
The broader analysis pooled 1,919 adults with obesity, with or without type 2 diabetes, from the STEP UP and STEP UP T2D trials. Of those, 1,312 received semaglutide 7.2 mg, 304 received the standard 2.4 mg dose, and 303 received placebo. At the start, more than 94% of participants were classified as high risk for fatty liver by the Fatty Liver Index, while fewer than 1% met FIB-4 criteria for advanced scarring risk. That suggests most had fat buildup rather than serious liver damage.
The liver fat result comes from a much smaller group. Novo said 55 participants in a STEP UP subgroup of adults with obesity but without diabetes had liver fat measured directly with MRI-PDFF, an imaging method the company called the gold standard for measuring liver fat. Of those, 26 started with liver fat above 5%, the common cutoff for excess fat, and 23 dropped below it by week 72.
Mean liver fat in the semaglutide group, which combined the 7.2 mg and 2.4 mg doses, fell from 8.8% to 3.1%, according to Novo. The release does not break down the 23 of 26 result by dose, and it reports no matching liver scan result for placebo patients. That makes it hard to know how much of the change came from the drug. In a group this small, one person shifts the percentage by nearly four points.
Fatty Liver, MASH, and Wegovy's Existing Approval
Doctors now call the most common form of fatty liver disease MASLD, or metabolic dysfunction-associated steatotic liver disease. It is linked to conditions such as obesity, insulin resistance, and type 2 diabetes, and the NIDDK describes it as usually a silent disease with few or no symptoms.
A more serious form, MASH, or metabolic dysfunction-associated steatohepatitis, adds inflammation and liver cell damage that can lead to scarring and cirrhosis.
The FDA granted accelerated approval to Wegovy in August 2025 for adults with MASH and moderate-to-advanced liver scarring. In the trial behind that approval, 63% of Wegovy patients had MASH resolve without worsening scarring at 72 weeks, compared with 34% on placebo. The trial will continue for a total of 240 weeks to see whether those gains lower the risk of death, liver transplant, and other liver-related events.
The new analysis is different. It measures liver fat in people enrolled in weight loss trials, not inflammation or scarring in people diagnosed with MASH. Novo also said the 7.2 mg dose, which the FDA approved in the U.S. as Wegovy HD for weight management, is not being studied for MASH.
What the Analysis Does and Does Not Show
Novo Nordisk ran the STEP UP trials and issued the release, and it stands to benefit commercially from the results. The findings have not yet appeared in a peer-reviewed journal.
Dr. Eric Lawitz of the Texas Liver Institute and University of Texas Health San Antonio said, "This analysis showed that semaglutide reduced liver fat and was linked to better overall liver health in adults with obesity."
Filip Knop, Novo's senior vice president and chief medical officer, said, "These findings help us look beyond the number on the scale and better understand the quality of the weight loss seen with semaglutide."
The result fits earlier evidence that semaglutide can reduce liver fat. But it rests on 26 people, lacks a published placebo comparison, and comes from the drugmaker. People with obesity or type 2 diabetes can ask a clinician whether liver testing makes sense, and those already taking Wegovy should not change their dose based on this analysis.
Key Questions Answered
What did the new Wegovy liver analysis show? Of 26 trial participants with obesity who started with liver fat above 5%, 23 reached normal levels by week 72 on semaglutide.
Why are the numbers considered small? Only 55 people in one trial subgroup had MRI liver scans, and just 26 of them started with excess liver fat.
Is Wegovy already approved for liver disease? Yes. Wegovy received FDA accelerated approval in August 2025 for adults with MASH and moderate-to-advanced liver scarring.
Who funded the research? Novo Nordisk, which makes Wegovy, ran the trials and released the findings, which have not yet been peer reviewed.
Who is most at risk for fatty liver disease? People with obesity, insulin resistance, or type 2 diabetes face higher risk, according to the NIDDK.
Should people start Wegovy to treat fatty liver? This analysis alone does not support that. People should talk with a clinician about testing and treatment options.
Published by Medicaldaily.com
