Could GLP-1 medications be the future of fatty liver disease treatment?

Humans tend to love animals — especially the fuzzy, cuddly kind. I’m no exception. Anyone who knows me knows my devotion to my three cats: Bruce Lee, Ruth Bader-Ginspurrg, and Houdini. Dogs are another favorite, though I don’t currently have the time or patience for one. Reptiles, however, have never inspired much affection in me. They lack fur, warmth, and the comforting illusion that they might love you back.

One reptile in particular used to strike fear into my soul: the Gila monster. As it turns out, that slow-moving, venomous desert lizard would one day help change modern medicine — and possibly the future of liver disease treatment.

I grew up in the desert, where lizards were everywhere. Most of them were harmless and oddly charming in a prehistoric way. My siblings and I kept them as temporary pets — easy to catch, easy to care for, and easy to mourn when they inevitably disappeared. The one exception was my brother Kenny’s beloved lizard, Burt. Kenny sang Burt to sleep every night with a heartfelt, off-key version of Gordon Lightfoot’s “Sundown.”

Burt’s story ended abruptly when he fell into a freshly dug fence posthole and was never recovered. As a mean older sister, I later weaponized my own cruel rendition of “Sundown” whenever Kenny annoyed me. He cried. I felt powerful. I also had no idea that lizards could one day matter quite so much to my survival.

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Monsters and MASH

Fast forward a few decades. The Gila monster (Heloderma suspectum) is now famous not for its bite, but for its saliva. Scientists studying the lizard in the 1980s discovered a compound that mimicked the GLP-1 hormone in the human body, which helps to regulate blood sugar. That discovery eventually led to the development of GLP-1 receptor agonists, a class of drugs that are now household names: Ozempic (semaglutide), Wegovy (semaglutide), Mounjaro (tirzepatide), and others.

Originally developed to treat type 2 diabetes, GLP-1 medications slow gastric emptying, reduce appetite, and stimulate insulin release while suppressing the secretion of the hormone glucagon. Their weight-loss effects were initially considered a side benefit. That side benefit has since become the headline.

Today, these drugs are widely prescribed for diabetes and obesity, and they’ve become the not-so-secret weapons of Hollywood and Silicon Valley alike. But celebrities aren’t the only ones paying attention. Gastroenterologists and hepatologists are increasingly interested in GLP-1 drugs for patients with fatty liver disease, including those of us living with metabolic dysfunction-associated steatohepatitis, or MASH.

While the U.S. Food and Drug Administration has not yet approved GLP-1 medications specifically for MASH, multiple studies have shown that these drugs can reduce liver fat, improve insulin resistance, and help patients make sustainable dietary changes by controlling hunger. Weight loss alone is a powerful tool in slowing liver disease progression, and these medications help many patients achieve it when lifestyle changes alone fall short.

Weighing the potential risks and benefits

That doesn’t mean they’re easy. Side effects like nausea, vomiting, and diarrhea are common, particularly as the dose increases. For people who already live with chronic gastrointestinal symptoms — something many liver disease patients know all too well — that’s a serious consideration. I know several people who swear by these medications, and others who couldn’t tolerate them at all.

As someone who has wrestled with weight for most of my life, I’ve been curious, but cautious. I don’t know many MASH patients who are eager to try GLP-1 agonists just yet. Many of us are waiting for clearer guidance from our doctors, more long-term data, and reassurance that the benefits outweigh the risks for our specific situations. It’s certainly on my list of future conversations.

One particularly intriguing area of research suggests GLP-1 drugs may also reduce cravings for alcohol — another major factor in liver disease. If that benefit holds up, it could be game-changing.

So why isn’t everyone using them? Cost is often the short, infuriating answer. Even with insurance, monthly copays can reach $100 or more — if the drug is covered at all. Uninsured patients often face prices near $1,000 a month, though some programs and pharmacies offer lower self-pay options. Like so many medical breakthroughs, access remains uneven.

Perhaps one day, GLP-1 medications — or drugs inspired by them — will become a standard part of MASH treatment. Until then, managing symptoms, maintaining follow-up care, and doing what we can to slow disease progression remain our best tools.

And somewhere out in the desert, a slow, stubborn lizard continues to remind us that science often finds hope in the most unexpected places.

Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.

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