Antiobesity Medications Show Promise for Liver Disease in Adults and Children

Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD/NASH, represent a global health crisis, often co-existing and driving severe metabolic complications. Despite their high prevalence, effective pharmacological treatments for MASLD, especially those that address both the liver pathology and underlying obesity, remain limited. This review addresses the comprehensive efficacy of current antiobesity medications (AOMs) across different age groups and specific MASLD outcomes.

The review found that AOMs consistently demonstrated significant weight loss, with GLP-1 receptor agonists achieving 10-15% total body weight reduction in adults over 68 weeks, and dual GIP/GLP-1 agonists showing even greater reductions of 15-22.5% over 72 weeks. Crucially, these medications also showed substantial improvements in MASLD markers. Liver fat content, measured by MRI-PDFF, decreased by 30-50% in treated groups compared to controls (p<0.001), along with significant reductions in liver enzymes (ALT/AST reductions of 20-40%). The most impactful finding was the potential for MASLD resolution, with semaglutide demonstrating 59% resolution of steatohepatitis (NASH) without worsening fibrosis in a Phase 2 trial, significantly higher than 17% in the placebo group (p<0.001). In pediatric cohorts, while data is less extensive, AOMs like liraglutide led to 8-10% weight loss and notable reductions in liver enzymes, suggesting similar benefits and a promising therapeutic avenue for children.