Novo’s Wegovy® (semaglutide) reduced liver fat to normal levels in 9 out of 10 adults with obesity and excess liver fat – EASD2026

Wegovy® cut liver fat to normal in 88.5% of obese adults after 72 weeks.

What the company is saying

Novo Nordisk is highlighting new post hoc analysis from the STEP UP trial, presented at EASD 2026, showing that Wegovy® (semaglutide 7.2 and 2.4 mg) led to normalization of liver fat in 88.5% of adults with obesity and excess liver fat after 72 weeks. The company frames this as a major clinical benefit, emphasizing that mean liver fat dropped from 8.8% to 3.1% in the treated group and that benefits were seen even in those with low baseline liver fat. The release positions semaglutide as a potential early intervention for liver disease, referencing expert commentary from Eric Lawitz, MD, and Filip Knop, Novo’s chief medical officer, to reinforce credibility. Novo also references the ongoing ESSENCE phase 3 trial in MASH, noting that semaglutide 2.4 mg showed superior improvement in liver fibrosis with no worsening of steatohepatitis in part 1, but provides no numerical efficacy data for this endpoint. The company underscores regulatory approvals for Wegovy® in the United States, Canada, United Kingdom, China, and other markets, and notes its global scale with over 67,000 employees. The tone is confident, but some claims—such as improvements in participants with low baseline liver fat—are not supported by specific data.

What the data suggests

The STEP UP pooled analysis included 1,919 adults, with 1,312 receiving semaglutide 7.2 mg, 304 receiving 2.4 mg, and 303 on placebo. In a sub-population of 26 participants with liver fat above 5%, 88.5% (23 people) achieved normal liver fat levels below 5% after 72 weeks of Wegovy® treatment. Mean liver fat in the semaglutide group dropped from 8.8% at baseline to 3.1% at week 72, a reduction of nearly two-thirds. At baseline, over 94% of all participants were high risk for fatty liver by Fatty Liver Index, but fewer than 1% met criteria for advanced fibrosis. The ESSENCE trial randomised 1,197 participants with MASH for 240 weeks; part 1 showed semaglutide 2.4 mg improved liver fibrosis and resolved steatohepatitis versus placebo, but no numerical results are disclosed. Wegovy® is approved for MASH in the United States, Canada, United Kingdom, China, and other markets. The data on liver fat reduction is robust for the small sub-population, but broader efficacy and long-term outcomes await further results, especially from ESSENCE part 2 due in 2029. Some claims, such as benefits in those with low baseline liver fat, lack supporting numbers.

Analysis

The announcement is generally positive in tone, highlighting significant reductions in liver fat among a sub-population in the STEP UP trial and referencing regulatory approvals for Wegovy® in multiple markets. The data for the STEP UP sub-population is specific and supported by numerical evidence (e.g., 88.5% of 26 participants achieved normal liver fat levels by week 72). However, some claims, such as improvements in participants with low baseline liver fat and the superiority of semaglutide in the ESSENCE trial, are not substantiated with numerical data. The most forward-looking element is the expectation of ESSENCE part 2 results in 2029, indicating a long-term timeline for further clinical milestones. There is no disclosure of financial or profitability metrics, and no large capital outlay is described, so the capital intensity flag is false. The gap between narrative and evidence is moderate: while the clinical data for the sub-population is robust, the broader claims about liver health improvements and future trial outcomes are less substantiated.

Risk flags

• ●The STEP UP liver fat reduction results are based on a small sub-population (26 participants with elevated liver fat), which limits generalizability and statistical power for broader populations.
• ●Some claims, such as improvements in participants with low baseline liver fat and superiority in the ESSENCE trial, are not supported by disclosed numerical data, reducing transparency and making it harder to assess the true magnitude of benefit.
• ●The most meaningful long-term efficacy and safety data from the ESSENCE trial will not be available until 2029, introducing a multi-year execution and data-readout risk for investors seeking confirmation of broader clinical and commercial impact.

Bottom line

Novo Nordisk’s new STEP UP analysis shows Wegovy® normalized liver fat in 88.5% of obese adults with excess liver fat after 72 weeks, with mean liver fat dropping from 8.8% to 3.1%. These results are robust for the small sub-population studied, but broader claims about efficacy in all patients and long-term disease modification are not yet substantiated by disclosed data. The ongoing ESSENCE trial in MASH, with 1,197 participants, will not deliver its next major results until 2029, so the timeline for confirming broader impact is long. Regulatory approvals for Wegovy® in major markets are already in place, supporting near-term commercial potential, but the most transformative clinical evidence remains years away. Investors should focus on the strength of the current sub-population data, the lack of numerical detail for some broader claims, and the long wait for ESSENCE part 2 results. The key takeaway: the clinical signal is positive but limited in scope, and the biggest catalysts are still several years out.

Announcement summary

(LSE:0QIU) Novo Nordisk presented a post hoc analysis from the STEP UP trial sub-population at the European Association for the Study of Diabetes (EASD) Annual Meeting 2026 in Milan, Italy, showing that Wegovy® (semaglutide 7.2 and 2.4 mg) reduced liver fat in adults with obesity without diabetes. Among 26 participants with liver fat above 5%, 88.5% (23 participants) achieved normal liver fat levels below 5% by week 72 of treatment. The mean liver fat in the group taking semaglutide declined from 8.8% at baseline to 3.1% at week 72, as measured by MRI. The STEP UP and STEP UP T2D trials pooled 1,919 adults, with 1,312 receiving semaglutide 7.2 mg, 304 receiving semaglutide 2.4 mg, and 303 receiving placebo. At baseline, more than 94% of participants across all groups were classified as high risk for fatty liver by the Fatty Liver Index (FLI), while fewer than 1% met criteria for advanced fibrosis risk by the FIB-4 index. The STEP UP trials were phase 3b randomised, double-blind, placebo-controlled studies evaluating semaglutide 7.2 mg once weekly versus semaglutide 2.4 mg and placebo for weight management, with primary endpoints of change in body weight and proportion of participants achieving ≥5% weight loss at week 72. The pooled analysis presented was exploratory and not a pre-specified primary or secondary endpoint. The ongoing ESSENCE phase 3 trial is evaluating once-weekly injectable semaglutide 2.4 mg in people with MASH and moderate to advanced liver fibrosis (stage F2 or F3), having randomised 1,197 participants 2:1 to receive semaglutide 2.4 mg or placebo for 240 weeks. In part 1 of ESSENCE, the objective was to demonstrate improvement in liver histology at 72 weeks based on biopsy sampling from the first 800 randomised patients, with semaglutide 2.4 mg showing superior improvement in liver fibrosis with no worsening of steatohepatitis, as well as resolution of steatohepatitis with no worsening of liver fibrosis compared to placebo. Results from part 2 of ESSENCE are expected in 2029. Semaglutide is marketed under the brand names Wegovy®, Ozempic®, and Rybelsus®. Wegovy® is approved for the treatment of MASH in the United States, Canada, the United Kingdom, China, and several other markets. Novo Nordisk employs over 67,000 people worldwide.

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