Is there an FDA-approved drug for fatty liver?

Yes, for MASH with moderate to advanced scarring (F2 to F3) and no cirrhosis: Rezdiffra (resmetirom) and Wegovy (semaglutide). Both are accelerated approvals that still need confirmatory trials. Simple fatty liver without MASH has no approved drug.

Is Wegovy approved for MASH?

Yes. The current Wegovy label includes noncirrhotic MASH with F2 to F3 fibrosis in adults, under accelerated approval. In its trial, MASH resolved in 63% versus 34% on placebo at 72 weeks.

Is tirzepatide approved for fatty liver?

No. In the phase 2 SYNERGY-NASH trial, MASH resolved in 44% to 62% of people on tirzepatide versus 10% on placebo at 52 weeks, but it has no MASH indication.

What is the difference between MASLD and MASH?

MASLD is fat buildup in the liver not caused by heavy drinking. MASH is the more serious form, with inflammation and liver cell damage that can lead to scarring.

Fatty Liver (MASLD, MASH): Drugs and the Evidence

Short answer: Two drugs are FDA approved for MASH, the inflamed form of fatty liver, in adults with moderate to advanced scarring but no cirrhosis: Rezdiffra (resmetirom) and Wegovy (semaglutide). Both were approved early, based on liver biopsies, and still need confirmatory trials. Tirzepatide had strong phase 2 results in SYNERGY-NASH but is not approved for MASH.

What people discuss for fatty liver (masld / mash)

What people discuss, and the strongest evidence we found for this goal
Compound	Best evidence	What it shows
Resmetirom (Rezdiffra)	FDA-approved for this	A daily pill for noncirrhotic MASH with F2 to F3 scarring. At 12 months, MASH resolved in 24% to 36% versus 9% to 13% on placebo, depending on dose and pathologist.
Semaglutide (Wegovy)	FDA-approved for this	Approved in adults for noncirrhotic MASH with F2 to F3 scarring. At 72 weeks, MASH resolved in 63% versus 34% on placebo.
Tirzepatide	Human trials	In SYNERGY-NASH (190 adults, 52 weeks, phase 2), MASH resolved in 44% to 62% versus 10% on placebo. Not approved for MASH.

"Animal or lab studies only" means no published human trial for this goal that we could find. Results in rats or cells often do not carry over to people. Compounds that are not FDA-approved have no tested label for dose, purity or safety.

What are MASLD and MASH?

MedlinePlus explains that MASLD (metabolic dysfunction-associated steatotic liver disease) is fat buildup in the liver not caused by heavy drinking. It used to be called nonalcoholic fatty liver disease. Simple fatty liver usually does not progress to liver damage.

MASH (formerly NASH) is the more serious form, with inflammation and liver cell damage. It can lead to fibrosis (scarring), and sometimes to cirrhosis or liver cancer. MASLD is more common with type 2 diabetes, obesity, high cholesterol or triglycerides, and high blood pressure.

Fibrosis is graded F0 (none) to F4 (cirrhosis). Both approved drugs cover F2 and F3, moderate to advanced scarring, and neither is for cirrhosis.

What do the trials show?

All three trials judged success by liver biopsy: whether MASH resolved without scarring getting worse, and whether scarring improved by at least one stage without MASH getting worse.

Biopsy results. Rezdiffra and Wegovy from label section 14; tirzepatide from the trial abstract.
Drug and trial	People, length	MASH resolved	Scarring improved
Rezdiffra 80 / 100 mg daily, label Trial 1	888 adults, 12 months	26-27% / 24-36% (placebo 9-13%)	23% / 24-28% (placebo 13-15%)
Wegovy 2.4 mg weekly, label Study 11	800 adults, 72 weeks	63% (placebo 34%)	37% (placebo 22%)
Tirzepatide 5 / 10 / 15 mg, SYNERGY-NASH	190 adults, 52 weeks	44% / 56% / 62% (placebo 10%)	55% / 51% / 51% (placebo 30%)

Rezdiffra ranges reflect two pathologists who read each biopsy separately. These trials enrolled different people and are not directly comparable. SYNERGY-NASH was a small phase 2 trial; its authors say larger and longer trials are needed.

How they work. Resmetirom acts on a thyroid hormone receptor (THR-beta) that is the main form in the liver. For semaglutide, the Wegovy label says the MASH mechanism is not fully understood and may involve weight loss and other factors.

Both approvals are accelerated approvals. Continued approval may depend on confirmatory trials showing a real clinical benefit, such as fewer liver complications.

Safety, and what is still unknown

Rezdiffra: the label warns about liver injury, gallstones and gallbladder inflammation, and raised statin levels. Diarrhea and nausea were the most common reasons people stopped. It says to avoid use in decompensated cirrhosis.
Wegovy: the usual GLP-1 warnings apply, including stomach side effects, gallbladder disease, pancreatitis and a rodent thyroid tumor warning.
Tirzepatide has no MASH indication, so there is no approved MASH dosing or monitoring plan.
Peptides sold for "liver health": we found no published human trial in MASH for any of them.

Diagnosis, prescriptions and dose changes belong with a licensed clinician who knows your history.

What is worth tracking

Liver tests such as ALT and AST as lab entries. The Rezdiffra label says to monitor liver tests during treatment.
Scan or stiffness results (FibroScan, MRI fat fraction) with dates, logged as lab entries.
Every dose, daily pill or weekly injection, so lab changes line up with what you took.
Weight weekly, since weight change is part of how semaglutide is thought to help.
Stomach or right-side belly pain, which can point to gallbladder problems listed on both labels.
Other medicines, especially statins, with start dates and changes.

Terms on this page: GLP-1 receptor agonist · GIP (glucose-dependent insulinotropic polypeptide) · Titration (dose escalation)

This page is education, not medical advice, and it is not a recommendation to use any compound. It does not cover dosing. Talk to a licensed clinician before starting, changing or stopping anything, and get diagnosed before treating a symptom.

Frequently asked questions

Sources

All goals and conditions · Compound guides · Glossary · Help center