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 I am trying to establish is whether the change in tolerance is the smaller stomach, the smaller body, or something central, and whether it settles.
Numbers rather than impressions, if you have them.
NurseKim_ATL 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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Shop Reference Standardsmarcus_mpls said:Alcohol simply stopped appealing, which I did not expect and which has been more socially complicated than the weight loss.
Same experience, arrived at from the opposite direction.
Adding the clinical framing, because it changes how the question reads. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.