Understanding Wegovy® Side Effects: What to Expect and How to Navigate Your Journey

Fatty liver disease, particularly non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH)—is now one of the most common liver conditions globally. Affecting up to 1 in 3 adults in New Zealand, it’s closely linked to overweight and obesity, type 2 diabetes, and insulin resistance.

But there’s promising news: GLP-1 receptor agonists, such as Wegovy (semaglutide), originally developed for diabetes and weight loss, are now showing powerful benefits for people with fatty liver disease.

Let’s look at how they work and what the latest research says.

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What Is NAFLD and Why Does It Matter?

NAFLD occurs when excess fat builds up in liver cells, not caused by alcohol. Over time, this fat can lead to inflammation (NASH), fibrosis (scarring), cirrhosis, and even liver cancer.

Unfortunately this a silent epidemic—often with no symptoms until the damage is severe.

Risk factors include:

• Obesity
• Insulin resistance
• Type 2 diabetes
• High cholesterol and triglycerides

There is currently no approved medication specifically for NAFLD or NASH. The mainstay of treatment has been lifestyle changes like weight loss and exercise. But maintaining long-term weight loss can be incredibly challenging.

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Enter: GLP-1 Receptor Agonists

GLP-1s (glucagon-like peptide-1 receptor agonists) are medications that:

• Improve insulin sensitivity
• Slow gastric emptying
• Reduce appetite
• Lead to substantial weight loss

Wegovy (semaglutide) is one of the most potent GLP-1s, approved for chronic weight management in New Zealand. But its benefits extend beyond weight loss.

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What the Research Says: GLP-1s and Liver Health

Here are some key studies and findings that show how GLP-1s can improve fatty liver disease:

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1. Semaglutide Improves NASH Histology

In a randomised controlled trial published in The New England Journal of Medicine (2021), researchers gave semaglutide to patients with biopsy-proven NASH.

✅ 59% of patients had NASH resolution with no worsening of fibrosis—compared to just 17% on placebo.

📖 Reference: Newsome PN et al. (NEJM, 2021) [1].

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2. Weight Loss Drives Liver Fat Reduction

GLP-1s induce 10–15% total body weight loss in many patients.

Even a 5–10% weight reduction is enough to significantly improve liver fat, inflammation, and fibrosis [2].

Semaglutide helps people reach these targets more reliably than diet and exercise alone.

📖 Reference: Armstrong MJ et al., The Lancet, 2016 [2].

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3. Reduces Liver Fat on Imaging

A 2020 study in The Lancet Gastroenterology & Hepatology found that semaglutide significantly reduced liver fat content on MRI-based imaging, even in non-diabetic individuals with NAFLD.

📖 Reference: Flint A et al., Lancet Gastroenterol Hepatol, 2020 [3].

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4. Improves Cardiometabolic Risk Factors

GLP-1s don’t just help the liver—they also improve:

• Blood sugar control
• Blood pressure
• Lipids (LDL, triglycerides)

These improvements reduce the overall cardiovascular risk in people with NAFLD, which is a leading cause of death in this population.

📖 Reference: Marso SP et al., NEJM, 2016 (LEADER trial) [4].

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5. Promising Real-World Data

Recent real-world cohort studies have shown that people with NAFLD on GLP-1 therapy experience reductions in liver enzymes (ALT, AST), indicating better liver function over time.

📖 Reference: Newsome PN et al., J Hepatol, 2021 [5].

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Are GLP-1s Right for You?

If you have fatty liver disease GLP-1s like Wegovy could offer a dual benefit:

✔️ Sustained weight loss

✔️ Improvement in liver health

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At rfynd, we offer a medically supported GLP-1 weight loss program that includes:

• Prescription access (Wegovy, Saxenda, or similar)
• Specialist clinician support
• Nutrition and lifestyle coaching
• Optional liver health monitoring

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Final Thoughts to consider

Fatty liver disease is more common—and more serious—than many people realise. Fortunately, science is catching up. GLP-1 medications like Wegovy are emerging as powerful tools, not just for weight loss but for protecting your liver and reducing long-term health risks.

Want to explore if Wegovy is right for your liver health journey?

👉 Book a consultation with one of our rfynd medical team today

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What About Bariatric Surgery for Fatty Liver Disease?

While medications like Wegovy are powerful tools for weight loss and liver health, for some people—particularly those with a BMI >30 —metabolic (bariatric) surgery may offer the most dramatic and lasting improvement in fatty liver disease.

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Here’s what the evidence shows:

1. High Rates of NASH Resolution and Fibrosis Improvemen

In one of the largest long-term studies published in Gastroenterology (2015), researchers followed 180 patients with biopsy-proven NASH who underwent bariatric surgery.

✔️ 85% achieved NASH resolution

✔️ 34% had fibrosis regression

📖 Reference: Lassailly G et al., Gastroenterology, 2015 [6].

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2. Massive Reductions in Liver Fat and Inflammation

A meta-analysis published in Obesity Surgery (2020) reviewed 32 studies and found bariatric surgery resulted in:

• 91.6% reduction in steatosis
• 81.3% resolution of NASH
• 65.5% improvement in fibrosis

📖 Reference: Lee Y et al., Obes Surg, 2020 [7].

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3. Liver Function Markers Improve Quickly

Within 6–12 months of surgery, liver enzymes (ALT, AST) typically fall to normal or near-normal levels. Improvements often occur before full weight loss is achieved, suggesting mechanisms beyond just fat loss—such as improved insulin sensitivity and gut hormone regulation.📖 Reference: Mathurin P et al., Journal of Hepatology, 2009 [8].

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‍4. Lowers Risk of Cirrhosis and Liver-Related Death

A large retrospective study from JAMA (2021) showed that bariatric surgery in patients with obesity and NAFLD was associated with:

• 48% reduced risk of developing advanced liver disease
• 70% reduction in liver-related mortality

📖 Reference: Aminian A et al., JAMA, 2021 [9].

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5. Reduces Overall Cardiometabolic Risk and Mortality

Since NAFLD is a multi-system disease, patients benefit not only from improved liver health but also:

• Better blood sugar control
• Improved lipid profile
• Lower cardiovascular risk and cancer risk
  

📖 Reference: Sjöström L et al., New England Journal of Medicine, 2007 [10].

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Surgery vs. Medication: Complementary Options

While GLP-1s and bariatric surgery both improve fatty liver disease, the choice depends on the individual:

• GLP-1s are ideal for those seeking non-invasive therapy or who aren’t surgical candidates.
• Bariatric surgery offers a more pronounced and durable option—especially for those with a BMI>30.

At rfynd, we work with you to explore both options, offering:

• GLP-1 medical weight loss programs
• Bariatric surgery with trusted surgeons
• Ongoing liver monitoring and health coaching

Want to explore if bariatric surgery is right for your liver health journey?

👉 Book a consultation with one of our rfynd surgeons today.

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Whats the hype?

If you’ve struggled with dieting, calorie counting, gym memberships, or trendy detoxes that promise the world but deliver disappointment — you’re not alone. At rfynd Weight Loss, we work with people like you every day who’ve “done all the right things” and still feel stuck.

Wegovy® (semaglutide) has sparked major interest — not just from celebrities or social media, but from serious clinical research. The STEP trials (Semaglutide Treatment Effect in People with obesity) offer clear, trustworthy evidence behind how well Wegovy works, who it helps, and what results you can expect.

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Here’s a breakdown of the STEP 1–5 clinical trials

🧪 What Are the STEP Trials?

The STEP Trials includes five large, global clinical trials that tested Wegovy’s effect on weight loss (compare to placebo) in people with obesity or overweight. These trials involved thousands of real people — like you — looking for lasting solutions. Most had tried and failed with diet and exercise alone. By the way, “placebo’s” are treatments with no active ingredients.

STEP 1: Wegovy vs. Placebo (and no diabetes)

📊 Participants: 1,961 adults with obesity or overweight
⏱ Duration: 68 weeks
💊 Treatment: Wegovy 2.4 mg weekly vs placebo, both with lifestyle advice

✅ Results:

• Average 14.9% weight loss with Wegovy vs 2.4% with placebo
• Over 1 in 3 people lost more than 20% of their body weight

👩‍⚕️ What this means for you:
Most participants were women in their 40s and 50s, but men were also included. This is the gold-standard trial showing that Wegovy helps people finally lose real, significant weight, even after many failed attempts.

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STEP 2: Wegovy in people with Type 2 Diabetes

📊 Participants: 1,210 adults with obesity/overweight + type 2 diabetes
⏱ Duration: 68 weeks
💊 Treatment: Wegovy 2.4 mg vs semaglutide 1 mg vs placebo

✅ Results:

• Average weight loss was 9.6% with Wegovy vs 3.4% with placebo
• Improvements in HbA1c and blood sugar control

👩‍⚕️ What this means for you:
Even if you have type 2 diabetes (a common condition in those with obesity), Wegovy still offers meaningful weight loss and improves blood sugar. Results are slightly less than STEP 1 due to insulin-related effects, but still impressive.

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STEP 3: Wegovy + Intensive Lifestyle Support

📊 Participants: 611 adults with obesity
⏱ Duration: 68 weeks
💊 Treatment: Wegovy 2.4 mg + intensive behaviour therapy vs placebo + therapy

✅ Results:

• Wegovy group lost 16% of body weight vs 5.7% in placebo
• Faster weight loss with early improvements in mood and energy reported

👩‍⚕️ What this means for you:
When Wegovy is combined with personalised coaching and support results are even better. This trial shows how mindset, movement, and medication work together. This is another reason why rfynd has built a team of support around you.

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STEP 4: What Happens If You Stop Wegovy?

📊 Participants: 902 adults who lost weight on Wegovy
⏱ Duration: 48 weeks (after initial 20-week run-in)

✅ Results:

• Those who stayed on Wegovy maintained their weight loss
• Those who stopped gained back ~6.9% of their weight

👩‍⚕️ What this means for you:
Wegovy isn’t a quick fix — it's a long-term tool. But with the right support, you can maintain your results. Think of it as a foundation, not a forever dependency.

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STEP 5: Long-Term Wegovy Use – Over 2 Years

📊 Participants: 304 adults
⏱ Duration: 2 years
✅ Results:

• 15.2% average weight loss over 104 weeks
• Most weight lost in the first year, maintained in year two

👩‍⚕️ What this means for you:
Long-term weight loss is possible and sustainable. This is key is you’re looking for lasting change, not yo-yo diets.

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❤️ Final Thoughts

The STEP trials clearly show that Wegovy is more than hype — it’s a clinically proven tool for meaningful, sustained weight loss. And for those of you who’ve spent years trying and failing with typical diets, this can feel like a breath of fresh air.

But weight loss isn’t just about medication. At rfynd Weight Loss, we blend expert care, mindset coaching, and nutrition planning into a personalised, shame-free program tailored for you.

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👉 What’s Next?

📖 Read this next:
Understanding Wegovy® Side Effects – So you know what to expect before you begin

📖 Or check out:
Strategies to Manage Side Effects of Wegovy® – For practical, easy-to-follow tips to stay on track

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Starting Wegovy® is a big decision — and feeling your best while on it is key to success. At rfynd Weight Loss, we’ve guided many women and men through the ups and downs of weight loss medications. Below are practical, simple tips to help you manage the most common side effects of Wegovy.

1. Nausea, Vomiting, and Diarrhoea

These usually settle over time. Here’s what helps:

• Eat small, bland meals – Think toast, rice, or soup.
• Avoid greasy or spicy food, especially in the first few hours after your injection.
• Stay hydrated – Sip water or electrolyte drinks often.
• Ginger tea or peppermint can ease nausea.

2. Constipation

Constipation can linger longer than other symptoms, but there’s help:

• Add fibre slowly into your diet (oats, veggies, kiwi fruit).
• Drink 2+ litres of water daily.
• Stay active – a daily walk supports gut movement.
• Consider a gentle laxative (e.g. macrogol or docusate) if needed – check with your clinician.

‍3. Hair Thinning

Hair loss may occur with rapid weight loss:

• Ensure you’re getting enough protein and essential nutrients.
• Consider a salon shampoo designed to prevent hair loss.
• Most people notice regrowth within a few months.

4. Gallbladder Care by:

• Avoiding extreme fasting or crash diets.
• Staying well-hydrated.
• Eating regular meals with some healthy fats to keep bile flowing.

5. Heart Rate & Skin Sensations

These usually don’t require treatment, but keep your medical team updated if symptoms persist.

When to Seek Help

Contact your health care professional if you:

• Have severe stomach pain
• Experience symptoms of low blood sugar (shaking, sweating, confusion)
• Notice changes in vision
• Are feeling unsure about how you're coping

📖 Want more information? Read our blog on Understanding Wegovy® Side Effects for a full breakdown.

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