Fouad Y, Abdelghany WA, El Sheemy R. Anti-obesity medications, the new frontiers in metabolic dysfunction-associated fatty liver disease: Efficacy, limitations, and future directions. World J Hepatol 2026; 18(5): 118303 [DOI: 10.4254/wjh.v18.i5.118303]
Corresponding Author of This Article
Yasser Fouad, Department of Gastroenterology and Endemic Medicine, Faculty of Medicine, Minia University, El Omoumy Road, Minya 61511, Egypt. yasserfouad10@yahoo.com
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Gastroenterology & Hepatology
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review-article
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Fouad Y, Abdelghany WA, El Sheemy R. Anti-obesity medications, the new frontiers in metabolic dysfunction-associated fatty liver disease: Efficacy, limitations, and future directions. World J Hepatol 2026; 18(5): 118303 [DOI: 10.4254/wjh.v18.i5.118303]
World J Hepatol. May 27, 2026; 18(5): 118303 Published online May 27, 2026. doi: 10.4254/wjh.v18.i5.118303
Anti-obesity medications, the new frontiers in metabolic dysfunction-associated fatty liver disease: Efficacy, limitations, and future directions
Yasser Fouad, Wafaa A Abdelghany, Reem El Sheemy
Yasser Fouad, Department of Gastroenterology and Endemic Medicine, Faculty of Medicine, Minia University, Minya 61511, Egypt
Wafaa A Abdelghany, Department of Endemic Medicine and Gastroenterology, Minia University, Minya 19124, Egypt
Reem El Sheemy, Department of Tropical Medicine, Faculty of Medicine, Minia University, Minya 61511, Egypt
Author contributions: Fouad Y designed the study; Abdelghany WA and El Sheemy R collected the data. All authors participated in writing and revising the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Yasser Fouad, Department of Gastroenterology and Endemic Medicine, Faculty of Medicine, Minia University, El Omoumy Road, Minya 61511, Egypt. yasserfouad10@yahoo.com
Received: December 29, 2025 Revised: January 4, 2026 Accepted: February 10, 2026 Published online: May 27, 2026 Processing time: 148 Days and 16 Hours
Abstract
The convergence of the global obesity and metabolic dysfunction-associated fatty liver disease (MAFLD) pandemics necessitates innovative therapeutic strategies. Anti-obesity medications, especially incretin-based treatments such as glucagon-like peptide-1 receptor agonists and multi-agonists (e.g., tirzepatide, retatrutide), have shown a strong ability to reduce body weight and to significantly improve inflammation, hepatic steatosis, and MAFLD biomarkers. The mechanistic transition from satiety induction to synergized energy expenditure is highlighted in this review, which critically evaluates the evidence supporting these agents. Notwithstanding its apparent effectiveness, obstacles such as a dearth of reliable fibrosis regression data, the possibility of sarcopenia, notable side effects, financial and insurance-related obstacles, and the widespread problem of weight gain after stopping all therapeutics reduces enthusiasm. The full potential of anti-obesity medications in MAFLD will ultimately necessitate a multimodal strategy that tackles these constraints through systemic change, multidisciplinary care, and future research.
Core Tip: Novel anti-obesity drugs, especially incretin-based treatments, successfully lower body weight and enhance metabolic dysfunction-associated fatty liver disease indicators like inflammation and steatosis. However, there are major obstacles that limit their long-term potential. These include the frequent recurrence of weight gain following discontinuation, significant side effects, high costs, risks of muscle loss, and inadequate data on fibrosis reversal. In addition to additional research and systemic healthcare reforms to address these limitations, a comprehensive, multidisciplinary approach is necessary to fully realize the potential of these medications for metabolic dysfunction-associated fatty liver disease.
