Journal of obesity & metabolic syndromeJul 9, 2026

Drug Treatments for Fatty Liver Disease Linked to Metabolism in the Age of Obesity and Metabolic Medicine

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jul 10, 2026

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide.

Weight loss through positive health behavior changes is essential for managing MASLD.
Two pharmacological agents, resmetirom and semaglutide, have received conditional approval for treating metabolic dysfunction-associated steatohepatitis (MASH).
There is a significant need for effective pharmacological therapy for MASH-related cirrhosis.
Emerging therapies include incretin-based treatments and fibroblast growth factor-21 analogues.
Non-invasive tests are recommended for treatment selection and monitoring responses.

Simplified

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and a major cause of cirrhosis, hepatocellular carcinoma, and liver-related mortality. Weight loss via positive health behavioral change is the cornerstone of management of MASLD. However, this is a huge challenge for many patients, highlighting the need for effective pharmacological therapies. Two pharmacological agents have received conditional approval for the treatment of metabolic dysfunction-associated steatohepatitis (MASH), the progressive inflammatory form of MASLD, namely resmetirom, an oral, liver-directed, selective thyroid hormone receptor-β agonist, and semaglutide, a glucagon-like peptide-1 receptor agonist. Despite recent advances, effective pharmacological therapy for MASH-related cirrhosis remains an unmet need, underscoring the importance of early identification and intervention. This narrative review summarizes the current pharmacological therapy landscape of MASLD, including emerging incretin-based therapies and fibroblast growth factor-21 analogues, as well as current guidance on the use of non-invasive tests for treatment selection and monitoring for treatment response. It also provides a background on recent advances in obesity and metabolic medicine, highlighting the evolving paradigm of complication-centric obesity management and the potential role of incretin-based therapies as the backbone of the management of obesity and obesity-related conditions, including MASLD.

Drug Treatments for Fatty Liver Disease Linked to Metabolism in the Age of Obesity and Metabolic Medicine

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