Can Tirzepatide Help with Fatty Liver Disease and NASH?

In this blog post, we will explore what NASH and fatty liver disease are, how tirzepatide works, and the potential benefits of using it to treat these conditions.

April 20, 2023

Can Tirzepatide Help with Fatty Liver Disease and NASH?


Tirzepatide is a promising new drug that has recently shown potential in treating non-alcoholic steatohepatitis (NASH) and fatty liver disease. In this blog post, we will explore what NASH and fatty liver disease are, how tirzepatide works, and the potential benefits of using it to treat these conditions.

What is NASH and Fatty Liver Disease?

Non-alcoholic fatty liver disease (NAFLD) is a condition in which too much fat is stored in the liver cells. The excess fat can cause inflammation and scarring in the liver, leading to more serious conditions such as NASH. NASH is a more severe form of NAFLD in which inflammation and liver cell damage are present, and there is a risk of developing cirrhosis or liver cancer. Fatty liver disease is becoming increasingly common, with an estimated 25% of the global population affected.

Current treatments for NASH and fatty liver disease are limited, with most recommendations focused on lifestyle changes such as diet and exercise. There are currently no FDA-approved medications specifically for treating NASH.

What is Tirzepatide?

Tirzepatide is a novel drug that belongs to the class of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Its mechanism of action involves mimicking the effects of these naturally occurring hormones in the body, which play a vital role in regulating blood glucose levels. Tirzepatide works by binding to and activating the GLP-1 and GIP receptors, resulting in the release of insulin and inhibition of glucagon secretion. This leads to a reduction in blood glucose levels, increased insulin sensitivity, decreased amount of fat stored in the liver, and a decrease in appetite. Additionally, tirzepatide has been shown to promote weight loss, likely due to its ability to slow gastric emptying and increase satiety. 

Overall, tirzepatide's multifaceted mechanism of action makes it a promising treatment option for individuals with type 2 diabetes and obesity and the above effects may be beneficial for patients with NASH and fatty liver disease, as excess weight and obesity are common risk factors for these conditions. Tirzepatide is currently being studied for use in treating NASH and fatty liver disease in the SYNERGY-NASH and SURPASS clinical trials.

Is Tirzepatide Useful for Fatty Liver Disease and NASH?

Tirzepatide has shown promise in clinical trials for the treatment of NASH and fatty liver disease. In a recent phase 2 clinical trial of 316 patients with type 2 diabetes receiving either tirzepatide, dulaglutide, or placebo, those who received tirzepatide showed a significant reduction in fatty liver biomarkers compared to those who received a placebo (1). 

An editorial post about tirzepatide discussed how, in the SURPASS-3 clinical trial, liver fat content was more extensively reduced after treatment with tirzepatide than with insulin. More specifically, the relative decrease in LFC was 29.8%, 47.1%, and 39.6%, with tirzepatide at 5, 10, and 15 mg/week, respectively, compared to 11.2% with insulin degludec (2). These results are encouraging for patients with diabetes who are insulin-dependent and who have concomitant fatty liver disease.

Even with the results of these early trials, more research is needed to determine the long-term safety and efficacy of Tirzepatide for treating NASH and fatty liver disease. Additionally, the drug is still in clinical trials and has not yet been approved by the FDA for this use.


To wrap up this blog post, it is clear that tirzepatide is a promising new drug that may be great in the future for the treatment of NASH and fatty liver disease. Its ability to reduce liver fat, lower blood glucose levels, and promote weight loss make it an attractive option for patients with these conditions. If you would like to learn more about the benefits of tirzepatide and you are someone with type 2 diabetes or obesity (even without fatty liver disease or NASH), our physicians at Mochi Health can fill you in! We prescribe tirzepatide and many other medications for medication-assisted weight loss in a tele-health format for your convenience. 


  1. Hartman ML, Sanyal AJ, Loomba R, et al. Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes. Diabetes Care. 2020;43(6):1352-1355. doi:10.2337/dc19-1892
  2. Polyzos SA, Goulas A, Papaioannidou P. Tirzepatide for Diabetes and Obesity: A New Window to the Treatment of Non-alcoholic Steatohepatitis [published online ahead of print, 2023 Jan 6]. Curr Med Chem. 2023;10.2174/0929867330666230106103202. doi:10.2174/0929867330666230106103202

Dr. Constantine Joseph Pella, MD

Boston University Medical Center

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