SAT-680 Reduction of liver steatosis following semaglutide treatment, bariatric surgery, and conservative multimodal therapy in patients with obesity: real-world evidence from a german university obesity center

Abstract Disclosure: P. Lünswilken: None. K. Worobiec: None. J. Altrogge: None. L.S. Braun: None. S. Andrea: None. L. Jegodzinski: None. B. Wilms: None. J.U. Marquardt: None. S. Meyhöfer: None. Background and Aim: Obesity is a well-established risk factor for impaired liver health and the development of metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to assess the impact of state-of-the-art obesity treatment at a specialized obesity center on liver fat accumulation. Methods: A total of 191 patients with obesity (WHO class I-III) from a specialized university obesity center were stratified according to the applied treatment modality of conservative multimodal therapy (68 patients aged 20-73 years, BMI 43.1±0.7kg/m2), lifestyle intervention combined with GLP-1 receptor agonist semaglutide (61 patients aged 27-82 years, BMI 42.3±7.4kg/m2 receiving once weekly subcutaneous semaglutide 1.0±0.4mg), and bariatric surgery (62 patients aged 20-71 years, BMI 48.8±6.9kg/m2 with sleeve gastrectomy or gastric bypass). A retrospective 6-months follow-up was performed to compare the impact of the respective treatment modality. The primary endpoint was the change in liver steatosis measured by Controlled Attenuation Parameter (CAP) by FibroScan® (502 Touch device equipped with a XL probe). Secondary endpoints included changes in body weight and BMI. Results: All patients had liver steatosis prior to treatment, with CAP values of 336.25±59.93dB/m in the surgery group, 334.27±53.17dB/m in the semaglutide group, and 332.63±59.76dB/m in the conservative multimodal treatment group. CAP showed a significant decline across all three therapy groups after 6 months (p=0.002 for ANOVA treatment x time interaction), i.e. bariatric surgery reduced CAP by -71.2±89.9dB/m, semaglutide by -31.9±69.2 dB/m, and conservative multimodal therapy by -14.8±54.4 dB/m, respectively. Weight loss was most pronounced upon bariatric surgery (-35.01±10.55kg), followed by semaglutide treatment (-8.46±2.98kg) and lifestyle intervention (-3.33±4.42kg), which directly translates into respective reduction in BMI of -11.75±2.90kg/m2, -2.98±2.41kg/m2, and -1.14±1.58kg/m2, respectively. Accounting for all therapy groups, CAP reduction correlated with body weight loss (p=0.012, r=0.229) as well as BMI reduction (p=0.003, r=0.272). Conclusion: Obesity treatment was associated with significant reduction in liver steatosis with most pronounced improvements upon bariatric surgery and semaglutide treatment. These results underscore the effectiveness of weight reduction reversal of steatosis within just six months. In line with current guidelines, this highlights the importance of focusing on health outcomes along the reduction of body weight in treatment of obesity. Presentation: Saturday, July 12, 2025