Popular weight-loss drug also proves effective in treating serious liver diseases

A popular weight-loss drug, semaglutide, can now be added to the list of treatments for chronic conditions, as it has been shown to significantly reduce liver fat and scarring in patients. This likely lowers their risk of developing cancer or requiring a liver transplant.

Lasting impact

These findings come from a global study of 800 patients, published this week in The New England Journal of Medicine . "These weight-loss drugs could permanently change the field," says Harry Janssen, professor of hepatology at Erasmus MC in Rotterdam.

Over the past seven years, the number of liver transplants caused by fatty liver disease in the Netherlands has tripled to about fifty per year, he notes. This accounts for 20 percent of all liver transplants. Because potential donors are also increasingly affected by fatty liver, more and more livers are being rejected.

The number of people with fatty liver disease has grown in recent decades. More than a third of the world's population suffers from this condition, which is often caused by unhealthy lifestyle choices.

For most people, liver fat does not cause symptoms, but 4 percent of the Dutch population develops inflammation that can lead to cirrhosis. "The inflammation essentially eats away at healthy liver cells," Janssen explains. This results in the formation of scar tissue, which impairs liver function.

"Fatty liver is a silent killer," he says. "By the time symptoms appear, it is often too late for treatment." He estimates that several hundred patients in the Netherlands die each year from cancer or liver failure resulting from fatty liver disease.

Weight loss is the key

The international study involved patients from 37 countries, including the Netherlands. All participants had liver inflammation and scarring. Some patients received a weekly injection of the weight-loss drug semaglutide (which is the active ingredient in, among others, Ozempic ), while the others received a placebo.

In the semaglutide group, 63 percent of patients no longer had visible fat accumulation in the liver after a year and a half. In 37 percent, the amount of scar tissue had decreased.

Weight loss is likely the most important explanation, says Janssen, who was not involved in the study. The group receiving semaglutide lost an average of 11 percent of their body weight. This also helped patients better manage their blood sugar levels. "That has influenced the results, as it reduces liver inflammation," Janssen says. Side effects were limited to nausea and diarrhea.

The study will continue for another three years; Janssen expects the health benefits to become even more pronounced. "Fatty liver is easy to treat with weight loss," he says, "but it takes more time for scar tissue to disappear."

No fat, no scarring

The fact that the condition of fatty liver had improved in such a large group of patients after just a year and a half offers hope, he says: without fat deposits in the liver, scar tissue does not form. To determine whether the drug can prevent liver cancer and the need for transplants, the patients must be monitored for even longer.

The situation for the placebo group also improved significantly. For example, one-third of the patients who were given a placebo saw a reduction in liver fat deposits. "We see this often," Janssen says. "When patients participate in a study, they start living healthier lives."

Weight-loss drugs that mimic the gut hormone GLP-1 are gradually proving to be versatile: at the beginning of this year, it was revealed that users of these medications have a lower risk of developing 42 different diseases. In the Netherlands, their costs are currently reimbursed only for a small group of patients.

What does this mean for you?

The results of this study highlight once again how significant an impact being overweight has on various health issues, such as fatty liver disease. At Goodweigh we combine medications like semaglutide with online lifestyle coaching and monitoring to enable these very broad health benefits. Studies like this confirm that treating overweight is about more than just losing weight: it is an investment in overall health.