Survodutide targets visceral and liver fat, not just weight: Carel le Roux, Ph.D. | ADA 2026

Survodutide's latest phase 3 data, presented at the American Diabetes Association’s 2026 Scientific Sessions, show Boehringer Ingelheim's glucagon/GLP-1 dual agonist reduces fat in the places that matter most for metabolic health. In this interview with SYNCHRONIZE-1 lead author Carel le Roux, M.D., M.S.C., of the University College Dublin School of Medicine, he discusses the importance of understanding the types of fat lost, not just the number on the scale.

In SYNCHRONIZE-1, a 76-week trial of 725 adults with obesity or overweight but no type 2 diabetes, the drug drove up to 16.6% mean weight loss versus 3.2% on placebo. An MRI substudy showed that loss was mostly fat: visceral fat dropped as much as 34%, liver fat fell up to 63.1%, and lean mass accounted for no more than 10.8% of the total tissue change.

SYNCHRONIZE-MASLD, a 48-week trial in 218 adults with MASLD on a weekly 6.0 mg dose, told a similar story. Among treated patients, 84.2% hit at least a 30% reduction in liver fat versus 24.3% on placebo, and 61% saw liver fat normalize below 5%. Body weight dropped up to 12.2% against 1.0% on placebo, with ALT also improving. Gastrointestinal side effects were the most common adverse events across both trials, and 19% of SYNCHRONIZE-1 patients discontinued because of them versus 2.9% on placebo, though no new safety signals emerged.

For le Roux, that fat-versus-muscle distinction is key. "If we only focus on body weight, then we are missing the health gains that we can have," he said, explaining that knowing where adipose tissue sits and how it behaves is what indicates the metabolic benefit. Falling waist circumference and visceral fat translate to metabolic health, he noted — especially across the cardio-kidney-liver-metabolic space — while patients hold onto muscle.

"This body composition is reassuring to me as a provider, but also reassuring to our patients," he said.