Efficacy and safety of anti-obesity drugs in metabolic dysfunction-associated steatotic liver disease: An updated review

Table 1 Overview of anti-obesity drug classes, mechanisms of action, and weight loss effects in metabolic dysfunction-associated steatotic liver disease

Class	Drug	Dosage	Mechanism of action	Effect on body weight
GLP-1 RAs	Liraglutide	3.0 mg/day	GLP-1 receptor activation: Satiety, gastric emptying (↓)	8%-10%
GLP-1 RAs	Semaglutide	2.4 mg/week	GLP-1 receptor activation: Satiety, gastric emptying (↓)	10%-15%
Dual GLP-1/GIP agonists	Tirzepatide	5-15 mg/week	Combined GLP-1 and GIP receptor agonism	15%-20%
Triple GLP-1/GIP/glucagon agonists	Retatrutide	8-12 mg/week (in trials)	GLP-1, GIP, and glucagon receptor agonist	Up to 24%
FGF-21 analogs	Efruxifermin	28-70 mg/week (in trials)	FGF21 receptor agonist	Approximately 10%
CNS agents	Phentermine/topiramate	7.5/46 mg/day to 15/92 mg/day	Central appetite suppression via sympathomimetic + GABA modulation	7%-9%
CNS agents	Naltrexone/bupropion	8/90 mg BID	Opioid antagonist and dopamine/norepinephrine reuptake inhibitor	5%-6%

This table summarizes pharmacologic agents currently used or under investigation for weight management in patients with metabolic dysfunction-associated steatotic liver disease. It includes the drug class, name, dosage range, primary mechanism of action, and average weight loss percentages reported in clinical trials. This table supports treatment individualization based on therapeutic goals. GLP-1 RAs: Glucagon-like peptide-1 receptor agonists; GLP-1: Glucagon-like peptide-1; GIP: Glucose-dependent insulinotropic polypeptide; FGF-21: Fibroblast growth factor 21; CNS: Central nervous system; BID: Twice daily; GABA: Gamma-aminobutyric acid.