Could Wegovy protect your liver?

Wegovy, one of the weight loss medications that has recently made history in obesity management, has been shown to unexpectedly improve liver health. This is due to semaglutide, the active compound in Wegovy, which has demonstrated promising effects on liver enzymes and inflammation in people at risk of fatty liver disease.¹

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver conditions worldwide, affecting up to one in four people.¹ It can quietly progress from simple fat accumulation to more serious forms such as non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis and even liver cancer. With no licensed treatment available for NASH, semaglutide’s effects on liver biomarkers suggest it could potentially be licensed in the future for use to slow or possibly reverse the disease process.¹

A deeper look at semaglutide

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, meaning that it mimics the natural hormone GLP-1 found in your body, which makes you feel full. Originally developed for managing type 2 diabetes, it was found to promote significant weight loss and improve blood sugar control.² 

A recent study has shown that the benefits may go further. In two major trials, one focused on weight management and the other on cardiovascular health, semaglutide significantly reduced markers of liver damage and inflammation in people with obesity and/or type 2 diabetes.^1,3

How much of a difference did Wegovy make?

In the weight management trial, participants received daily semaglutide injections alongside dietary and exercise support. Among those with elevated ALT (an enzyme released into the blood when liver cells are damaged) at the start, treatment led to a 6–21% reduction in ALT levels, depending on the dose. At the highest dose (0.4 mg/day), up to 46% of patients saw their ALT return to normal ranges, compared with only 18% in the placebo group.¹

In the same group, hsCRP (a marker of inflammation) fell by as much as 43%, suggesting semaglutide might help reduce the inflammatory processes that drive liver scarring in NASH.¹

Although improvements in liver enzymes appeared to be closely linked to weight loss, researchers caution that weight is not the whole story. GLP-1 drugs like semaglutide also offer direct metabolic and anti-inflammatory benefits, and further research is needed to understand the full scope of their action on the liver.¹

What about people with diabetes and cardiovascular risk?

In study looking at heart health and semaglutide, which included older participants with type 2 diabetes and high heart disease risk, semaglutide was delivered weekly at doses of 0.5 or 1.0 mg.³ The higher dose produced a 9% reduction in liver markers (ALT) after two years.¹ 

The metabolic connection

Many liver conditions are closely linked with obesity, insulin resistance and metabolic syndrome. Many people with these liver conditions are first identified through routine checks showing abnormal liver enzymes, high cholesterol or elevated blood pressure. Semaglutide targets this cluster of problems by reducing body weight, improving glucose regulation, and now, potentially, calming liver inflammation.^1,2

In the weight management trial, participants saw substantial reductions in the prevalence of metabolic syndrome after 52 weeks of treatment.^1,3 Among those on the highest dose of semaglutide, the proportion with metabolic syndrome was halved compared with baseline, which wasn’t replicated in the placebo group.

What this means for patients with liver damage

Although these trials were not designed specifically to assess semaglutide’s impact on the liver, reductions in certain liver markers are consistent with improved liver health.¹ For patients already managing type 2 diabetes or obesity, both of which are closely tied to liver damage, semaglutide could offer a multifaceted treatment that addresses weight, blood sugar, heart health and liver protection all at once.¹

The caveats and the future

The results from this trial should be taken with a pinch of salt. The participants in these trials did not undergo liver biopsies (taking a sample from the liver), so while the reduction in certain liver markers is promising, they can’t be directly attributed to the treatment of liver disease. The findings also do not apply directly to patients with advanced liver disease such as cirrhosis, who were not included in the studies.¹

A dedicated phase 2 trial is already under way to assess semaglutide in patients who have undergone a liver biopsy.¹ If successful, this could mark the beginning of a new chapter in the treatment of fatty liver disease in which semaglutide or similar GLP-1 medications take the spotlight.¹

The numan take

Liver disease often progresses slowly and without symptoms until the liver is severely damaged. With no approved treatments and lifestyle changes proving difficult to sustain, new treatment options are desperately needed. Wegovy, already recognised for helping people lose significant amounts of weight, may soon prove valuable in protecting the liver. 

DIsclaimer: This blog is intended for informational purposes only and should not be considered medical advice. Always take your prescribed medication exactly as directed by your healthcare provider. Using medication outside of its prescribed purpose (off-label use) can lead to serious health risks.

References

1. ^{Newsome P, Francque S, Harrison S, Ratziu V, Van Gaal L, Calanna S, et al. Effect of semaglutide on liver enzymes and markers of inflammation in subjects with type 2 diabetes and/or obesity. Aliment Pharmacol Ther. 2019;50(2):193–203.}

2. ^{Kommu S, Whitfield P. Semaglutide. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.}

3. ^{Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221–32.}