Answering the narrow version, because the broad one does not have a single answer. The liver data is among the strongest non-weight findings in the class. The semaglutide MASH programme reported a large advantage over placebo on MASH resolution, with a substantial minority also achieving fibrosis improvement — and fibrosis is the endpoint that predicts outcomes. Mechanistically it is reduced hepatic lipogenesis, increased fatty-acid oxidation, less hepatic inflammation, and possibly a direct effect on stellate-cell activation.

Correct me if the detail matters more than I have assumed.

Dr.RaviCardio said:

The liver data is among the strongest non-weight findings in the class.

Agreed, and ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

RickReta_CO said:

Alcohol simply stopped appealing, which I did not expect and which has been more socially complicated than the weight loss.

Same pattern here, and in the same order. Nothing to add that would improve it.

Adding the clinical framing, because it changes how the question reads. If two explanations both fit, the useful question is which one predicts something the other does not. That is answerable; arguing about which sounds more plausible is not.