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. This condition is linked to metabolic issues and used to be known as NAFLD. The update focuses on using a drug called semaglutide, which is found in a medication named Wegovy. The FDA gave Wegovy the green light in August 2025 for treating MASH with moderate to advanced fibrosis. This decision was based on a study called ESSENCE. The study showed that after 72 weeks of using semaglutide, many patients saw improvements in their liver health. Specifically, 62. 9% of patients had resolution of MASH without worsening of fibrosis, compared to 34. 3% on a placebo. Additionally, 36. 8% of patients had a reduction in liver fibrosis without worsening of MASH, compared to 22. 4% on a placebo. Doctors now have guidelines on who should get this treatment. Patients with MASH and stage 2-3 fibrosis are good candidates. Doctors can use non-invasive tests like VCTE, MRE, or ELF to check the liver's condition instead of doing a biopsy. For patients with more advanced fibrosis, doctors need to be careful and make individualized decisions. Semaglutide is generally safe, but patients might experience some side effects like nausea, diarrhea, or constipation. These side effects are usually mild and temporary. Doctors should also watch out for rare but serious risks like kidney injury, gallbladder disease, and pancreatitis. 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. In summary, semaglutide offers a new and promising treatment option for MASH. With proper monitoring and lifestyle changes, it can significantly improve liver health.