New data from Novo Nordisk (NYSE: NVO) shows that Wegovy reduced liver fat to normal levels in the vast majority of adults with obesity who had elevated liver fat at the start of treatment.
The findings, presented at the European Association for the Study of Diabetes Annual Meeting 2026 in Milan, Italy, come from a post hoc analysis of a sub-population within the STEP UP trial program.
Among participants with liver fat above 5% at baseline, 88.5% of those taking pooled semaglutide 7.2 mg and 2.4 mg achieved normal liver fat levels below 5% by week 72 of treatment.
Mean liver fat in the semaglutide group declined from 8.8% at baseline to 3.1% at week 72, representing a reduction of nearly two-thirds over the course of treatment.
The sub-population analysis included 55 participants with excess liver fat, of whom 26 entered the trials with liver fat above the 5% threshold, and 23 of those reached normal levels by the end of the study period.
Eric Lawitz, MD, of the Texas Liver Institute and University of Texas Health San Antonio, said: “These findings suggest semaglutide may help address liver disease early, before it becomes a serious health problem, that could harm the heart, kidney, liver and metabolic health in the long term.”
Lawitz added that the significance of early intervention is amplified by the scale of the problem, noting that “as many as three in four people with obesity may have excess liver fat.”
The broader pooled analysis drew from 1,919 adults across the STEP UP and STEP UP T2D trials, with more than 94% of participants classified as high risk for fatty liver by the Fatty Liver Index at baseline.
Filip Knop, senior vice president and chief medical officer at Novo, said: “These findings help us look beyond the number on the scale and better understand the quality of the weight loss seen with semaglutide.”
Knop noted that the dedicated ESSENCE MASH trial had already demonstrated reversal of liver damage in people with MASH on semaglutide, and that the STEP UP analysis reinforces semaglutide’s beneficial impact on liver health in people with obesity more broadly.
Liver fat was measured using magnetic resonance imaging proton density fat fraction, described as the gold-standard imaging technique for quantifying hepatic steatosis, providing direct and non-invasive quantification of liver fat.
Wegovy is currently approved for the treatment of metabolic dysfunction-associated steatohepatitis, known as MASH, in the United States, Canada, the United Kingdom, China and several other markets.
The ESSENCE trial, an ongoing phase 3 study evaluating once-weekly injectable semaglutide 2.4 mg in people with MASH and moderate to advanced liver fibrosis, randomized 1,197 participants, with results from part 2 expected in 2029.
Semaglutide is a glucagon-like peptide-1 receptor agonist that mimics the naturally occurring hormone GLP-1, which regulates both blood sugar and body weight across a range of cardiometabolic conditions.
The drug is marketed under the brand names Wegovy, Ozempic, and Rybelsus, and has been tested in clinical development programs spanning type 2 diabetes, obesity, cardiovascular disease, heart failure, chronic kidney disease, and liver disease.
