Metabolic HealthSemaglutide Rivals Bariatric Surgery for Liver Health in Obese Patients
A prospective study of 92 adults with obesity and metabolic liver disease compared lifestyle therapy alone, semaglutide, and laparoscopic sleeve gastrectomy over 72 weeks. All groups showed improvements in hepatic steatosis, but bariatric surgery produced the largest absolute reductions in liver fat and stiffness. Remarkably, after adjusting for weight loss, semaglutide and surgery produced statistically similar improvements in liver stiffness — even though surgery patients lost three times as much weight. Semaglutide's liver benefits appear to operate through mechanisms beyond weight loss alone. Lifestyle modification showed limited benefit by comparison. One nuance: surgery slightly raised FIB-4 fibrosis scores while semaglutide kept them stable. These findings suggest GLP-1 receptor agonists may have direct hepatoprotective effects, making them a viable non-surgical option for managing MASLD.
