Retatrutide fatty liver estimator
Estimate hepatic fat reduction from retatrutide based on Phase 2 NAFLD sub-study data. 86% liver fat clearance observed. Includes fibrosis stage selector and projected outcomes.
Non-alcoholic fatty liver disease (NAFLD) affects approximately 25% of the global adult population — roughly 2 billion people. It represents a spectrum from simple steatosis (excess fat accumulation without inflammation) through non-alcoholic steatohepatitis (NASH, with inflammation) to fibrosis and cirrhosis. Currently, no pharmacological therapy is approved specifically for NAFLD treatment.
Retatrutide's Phase 2 clinical trial included a dedicated NAFLD sub-study that produced remarkable results. Among participants with baseline hepatic steatosis (≥5% liver fat by MRI-PDFF), retatrutide demonstrated 86% liver fat clearance at therapeutic doses. 93% of participants reached complete resolution — defined as liver fat below 5% by MRI. These are outcomes not achievable with diet alone in most patients and exceed what has been demonstrated with any current approved pharmaceutical.
The mechanism is distinct from the weight loss pathway. While GLP-1 and GIP receptor activation contribute to fat redistribution through weight loss, the glucagon receptor component drives hepatic-specific effects: glucagon receptor stimulation promotes hepatic fat oxidation (the liver burns its own stored fat as fuel), increases VLDL secretion (exporting fat out of the liver), and suppresses hepatic de novo lipogenesis (new fat production). These hepatic effects begin at the 4mg dose level and increase through the 12mg maximum.
Fibrosis stage is an important modifier. Patients with higher fibrosis stages (F2-F3) showed particular benefit from early escalation to therapeutic doses in the sub-study. The glucagon receptor's anti-fibrotic potential through hepatic stellate cell modulation is under active investigation.
This tool applies the Phase 2 sub-study data to provide personalized hepatic fat clearance projections based on fibrosis stage and current dose. For research use only.
calc.phase3Note
In a dedicated NAFLD sub-study, retatrutide cleared 86% of liver fat and returned 93% of patients to normal liver fat levels. No approved drug comes close to this outcome. 1 in 3 adults have fatty liver disease.
calc.liverFatReduction
86%
calc.patientsNormalized
93%
calc.projectedResidual
2.8–2.8%
calc.expectedTimeframe
24–36 weeks
Best outcomes at F0. Phase 2 data showed near-complete liver fat clearance at this stage. 93% of patients reached normal liver fat levels.
calc.recommendedCycle
| calc.weeks | calc.dose | calc.phase |
|---|---|---|
| 1–4 | 1 mg | Initiation — GI tolerance phase |
| 5–8 | 2 mg | Early escalation |
| 9–12 | 4 mg | Therapeutic range begins |
| 13–16 | 8 mg | Liver fat reduction accelerates |
| 17+ | 12 mg | Maintenance — maximum efficacy |
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Frequently asked questions
How does retatrutide reduce liver fat?+
Retatrutide reduces liver fat through glucagon receptor activation, which drives hepatic-specific metabolic changes: increased hepatic fat oxidation (the liver preferentially burns stored fat), increased VLDL secretion (exporting triglycerides out of the liver), and suppressed hepatic de novo lipogenesis (reduced new fat synthesis). These effects are additive to the general fat reduction from GLP-1-mediated weight loss and begin at the 4mg dose level.
What percentage of liver fat reduction can I expect with retatrutide?+
Phase 2 sub-study data shows 86% mean liver fat reduction from baseline at therapeutic retatrutide doses (≥4mg). 93% of participants with baseline steatosis (≥5% liver fat) reached complete resolution (fat <5%). The magnitude of reduction is dose-dependent — lower doses (1-2mg) show partial effects, with the full hepatic benefit emerging at the 4mg+ range.
How quickly does liver fat reduction occur with retatrutide?+
In the Phase 2 sub-study, significant liver fat reduction was detectable by MRI-PDFF at 24 weeks. The most rapid reduction occurs during the first 12-24 weeks of treatment as the liver fat metabolic state shifts. Unlike weight loss, which continues beyond 24 weeks, hepatic fat clearance largely occurs in the first 6 months of therapeutic dosing.
Are there other peptides that help with fatty liver disease?+
GLP-1 receptor agonists broadly (semaglutide, tirzepatide) show hepatic fat reduction, but the magnitude is substantially lower than retatrutide's glucagon-mediated effects. Semaglutide trials in NASH showed approximately 59% liver fat reduction. Tirzepatide's hepatic effects in NAFLD are under investigation but are expected to exceed GLP-1 monotherapy due to GIP receptor contributions. BPC-157 has demonstrated cytoprotective effects on hepatocytes in animal models but lacks the large-scale clinical NAFLD data that retatrutide has.
What fibrosis stage benefits most from retatrutide in NAFLD research?+
Phase 2 sub-study data suggests benefit across all fibrosis stages (F0-F3), with higher-stage patients (F2-F3) potentially benefiting most from earlier escalation to therapeutic doses. The glucagon receptor's potential anti-fibrotic mechanisms through hepatic stellate cell modulation are under active investigation. F4 (cirrhosis) was excluded from the sub-study — data in this population is not yet available.
Research background
toolShell.references
Jastreboff AM, Kaplan LM, Frías JP, et al. (2023). Triple-Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial title: . New England Journal of Medicine. DOI: 10.1056/NEJMoa2301972
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