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Finally, we outline the implications of adopting semaglutide as a disease-modifying agent in MASH with F2-F3 fibrosis, note the study limitations and remaining questions, and argue that combinatorial approaches targeting complementary metabolic and hepatocentric pathways may define the next phase of MASLD management

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Still, to pave the way for more widespread clinical applications of gut-based interventions, future research will need to shift emphasis on more reward phases and clinical populations, ideally using larger samples with publication of the associations regardless of their threshold as full maps and regardless of a potential confirmation or rejection of the hypothesized action on reward responses

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