GLP-1 receptor agonists should be considered for individuals with a BMI of 28-40 and stage 2 fibrosis who have maximized lifestyle modifications, with a discussion about coming off the medication and potential weight regain.

“when I have you know the average person who BMI 28 to 40 um they have stage two estimations from non-invasive tests um they've maximized their lifestyle modifications for their current demands in life um what are we working with endocrinologists most of them have already had the discussion if they have diabetes about bringing in a gp1 receptor Agonist um if they're not um we strongly um move forward that conversation but we don't do it outside of the context of at some point um you will likely have to come off of this medicine we need to talk about how many people regain the weight afterwards and what's the longitudinal benefit um for a long long itudinal disease um if two years down the road you regain the weight and the injury pattern re resumes so we we do take a long lens on it”