This one has a reasonably settled answer, so here it is. 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.
Alcohol simply stopped appealing, which I did not expect and which has been more socially complicated than the weight loss.
What would genuinely help is knowing whether the change in tolerance is the smaller stomach, the smaller body, or something central, and whether it settles.
Tell me what I have not thought of.
COA_Karl 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.
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Browse GL Biochemcarlos_SATX 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.
From the other side of the consultation, briefly. The distinction that resolves most of these threads is between what is true on average and what is true for one person. Both are real; they answer different questions and get quoted as if they were the same one.