The Study
Randomised trial comparing weight loss through lifestyle and GLP-1 receptor agonist therapy in people with MASLD
This study is like a fair race between two ways to lose weight: eating less and taking a medicine. It shows that during the race, the medicine helped with blood sugar and fats more than just eating less. But once the race ended, the medicine group started having weird body changes that didn’t happen in the eating group. So we know what happened during the race, but we don’t know if one way is better overall.
Analysis score
Maximum 45 for a randomized controlled trial.
Where the score came from
Two ways to lose weight—eating less or taking a drug—both shrink fat in the liver equally. But the drug also helps blood sugar and fat production in the liver while you're taking it. When you stop the drug, those benefits vanish and your body sends out strange signals that might make you gain weight again.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 545 / 100
Quality score
Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes—losing weight helps the liver no matter how you do it, but stopping the drug may trigger biological changes that make it harder to keep the weight off.
- 2Both groups lost ~5 kg and reduced liver fat by 7.5%.
- 3The drug group had better blood sugar and lower liver fat production during treatment.
- 4After stopping, blood sugar worsened and 4 inflammatory proteins (MMP-10, IL10RB, FGF-23, Flt3L) rose only in the drug group.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
JHEP Reports
Year
2025
Authors
A. Moolla, T. Poolman, Nantia Othonos, Jiawen Dong, Kieran Smith, T. Cornfield, Sarah White, David W. Ray, S. Mouchti, F. Mózes, Helena B. THOMAIDES-BREARS, Stefan Neubauer, J. Cobbold, L. Hodson, Jeremy W. Tomlinson
Related Content
Claims (10)
Liraglutide lowers blood glucose levels after eating and during fasting, and increases insulin sensitivity in people with obesity and prediabetes by directly activating GLP-1 receptors, without relying on weight loss or mechanisms shared with DPP-4 inhibitors or dietary weight loss.
In people with MASLD but without diabetes, losing the same amount of weight through diet and exercise or through liraglutide medication leads to similar decreases in liver fat and liver enzyme levels, suggesting that weight loss is the main factor improving liver health.
In adults with MASLD who do not have type 2 diabetes, stopping liraglutide leads to measurable increases in specific blood proteins and changes in gene activity in fat tissue after 12 weeks, but similar changes are not seen when people stop lifestyle changes like diet and exercise.
GLP-1 receptor agonists improve heart and metabolic health in people with type 2 diabetes and prediabetes through direct actions on GLP-1 receptors, without relying on weight loss or the body's natural incretin signals.
In adults with MASLD but without type 2 diabetes, 12 weeks of liraglutide treatment and lifestyle changes that produce the same amount of weight loss both reduce liver fat by about 7.5%, and the reduction is not greater with liraglutide than with weight loss alone.
In adults with MASLD but without type 2 diabetes, stopping liraglutide causes measurable increases in four specific blood biomarkers linked to inflammation and metabolism, while stopping lifestyle changes does not produce these changes.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.