It was reported that 23 of 26 participants who began with elevated liver fat had fallen below the 5% threshold after 72 weeks of treatment. The 88.5% finding came from participants receiving pooled 7.2-mg and 2.4-mg doses of semaglutide and was presented at the 2026 European Association for the Study of Diabetes Annual Meeting in Milan.

Although potentially encouraging, the result needs to be viewed in context.

Liver Fat Dropped Substantially During Treatment

The liver-imaging analysis involved 55 adults with obesity but without diabetes from the STEP UP program. Liver fat was assessed using magnetic resonance imaging.

Among participants receiving semaglutide, average liver fat declined from 8.8% at the beginning of the study to 3.1% at week 72. Of the 26 people whose initial liver fat exceeded 5%, 23 ultimately recorded a level below that threshold.

Because only 26 people contributed to the headline result, however, individual outcomes have a sizable effect on the percentage. The two semaglutide doses were also combined for the MRI result rather than reported separately. The company’s release did not provide a corresponding placebo MRI result, preventing a direct treatment-versus-placebo comparison for this particular endpoint.

Those limitations are particularly important because the analysis was conducted post hoc. Liver fat outcomes were not prespecified primary or secondary endpoints of the trials.

Larger STEP UP Dataset Included Nearly 2,000 Adults

The broader exploratory analysis pooled 1,919 participants from the STEP UP and STEP UP T2D studies. Of these, 1,312 received semaglutide 7.2 mg, 304 received 2.4 mg, and 303 received placebo.

At baseline, more than 94% of participants were categorized as being at high risk for fatty liver according to the Fatty Liver Index. Fewer than 1% met FIB-4 criteria indicating risk of advanced fibrosis.

The MRI findings, though, came from the much smaller STEP UP subgroup rather than the entire population.

Why Liver Fat Matters

Excess liver fat is closely associated with metabolic disease, particularly obesity and type 2 diabetes. The condition now commonly known as metabolic dysfunction-associated steatotic liver disease, or MASLD, can exist without obvious symptoms.

MASLD is also distinct from metabolic dysfunction-associated steatohepatitis, or MASH. MASH represents a more serious disease state involving liver inflammation and cellular injury and can be accompanied by progressive fibrosis.

That distinction is important when interpreting the new results. The STEP UP analysis examined changes in liver fat, not whether semaglutide reversed inflammation, fibrosis, or clinically significant liver disease.

Semaglutide 2.4 mg is separately used for MASH, while Novo Nordisk says the 7.2-mg dose examined in the broader STEP UP program is not being investigated as a MASH therapy.

Promising Signal, but Important Questions Remain

The results add to evidence connecting semaglutide treatment with improvements in measures of liver health, but they do not establish that nearly 9 in 10 patients with obesity taking Wegovy can expect their liver fat to normalize.

The headline percentage is based on just 26 participants with elevated liver fat at baseline. The analysis was exploratory, the semaglutide doses were pooled, and a placebo MRI comparison was not reported.

There is also an important source consideration: Novo Nordisk, Wegovy’s manufacturer, conducted the STEP UP program and announced the analysis. The post hoc liver-fat findings therefore warrant additional scrutiny and independent peer-reviewed evaluation before broader conclusions are drawn.

For patients, the findings should not be a reason to alter a Wegovy dose or treatment plan without medical guidance. Instead, people with obesity or metabolic risk factors who are concerned about fatty liver disease can discuss with a healthcare professional whether liver evaluation is appropriate.