Excellent results. A few clinical notes for context:
The triglyceride reduction of 56% is above what the STEP trials typically showed (~17-20% average), suggesting you may have been particularly responsive to the metabolic effects, or your dietary changes (especially cutting alcohol) contributed significantly. Alcohol is a major driver of elevated triglycerides.
The liver enzyme normalization is consistent with emerging data on semaglutide for NAFLD/NASH. There are actually ongoing trials (the ESSENCE trial) specifically studying semaglutide for NASH resolution.[1]
Regarding metformin discontinuation — I'd recommend discussing with your doctor keeping it even if A1C is normal. There's growing evidence that metformin has independent cardioprotective and potentially anti-aging effects beyond glucose control. Plus, the combination may help prevent weight regain.
One lab I'd recommend adding at your next visit: a fasting lipid panel with LDL-P (particle number) and Lp(a). Standard LDL-C doesn't tell the whole story, especially with rapid weight loss.
[1] Newsome PN, et al. "Semaglutide for NASH." N Engl J Med. 2021;384(12):1113-1124.
Last edited: Jun 3, 2026 at 11:00 AM