Assessing and Treating MASLD

In the third video of this series, PA Joseph Zucchi walks through the American Gastroenterological Association’s 2026 clinical care pathway for MASLD risk stratification and management. He explains which patients to screen and how to use a two-tier approach of noninvasive tests, starting with the FIB-4 score and followed by liver stiffness measurement or a blood-based fibrosis test when indicated.

PA Zucchi also reviews treatment strategies ranging from lifestyle intervention and obesity medications to currently approved therapies for MASH.

Key Takeaways:

Fibrosis risk stratification can be done using a two-tier approach that includes the FIB-4 and a second noninvasive fibrosis assessment.
Patients at lower risk of fibrosis can be managed in primary care.
PAs should consider lifestyle modification, obesity medications and/or surgical interventions, and treatment of cardiovascular risk factors as appropriate for each patient.

Previous Video Next Video

Speaker

Click on the photo below to learn more about the speaker.

Joseph Zucchi, PA-C, MPAS

References and Additional Resources:

Alexander L, Purnell JQ, Burridge K, et al. Joint TOS/OMA/OAC expert guidance statement on the pharmacological management of united states adults with overweight or obesity using the GRADE approach. Obesity. 2026;34(4):851–870. https://onlinelibrary.wiley.com/doi/10.1002/oby.70164

Kanwal F, Bril F, Wong V, et al. Clinical care pathway for the risk stratification and management of patients With Metabolic Dysfunction–Associated Steatotic Liver Disease. Gastroenterology. 2026;171:164-183. https://pubmed.ncbi.nlm.nih.gov/41812830/

REZDIFFRA. Prescribing Information. Madrigal Pharmaceuticals, Inc. 2026. https://www.madrigalpharma.com/wp-content/uploads/2026/07/Combined-USPI_USPPI-July-2026.pdf

Tondt J, Orr M, Damian A, et al. Obesity Algorithm 2026. https://obesitymedicine.org/resources/obesity-algorithm/. Accessed September 1, 2026.

Wegovy. Prescribing Information. Novo Nordisk, Inc; 2026. https://www.novo-pi.com/wegovy.pdf

Supported by

Joseph Zucchi, PA-C, MPAS

Joseph Zucchi is the Clinical Supervisor and physician associate at Transition Medical Weight Loss in Salem, New Hampshire, where he leads a multidisciplinary obesity medicine program dedicated to comprehensive care. Under his clinical leadership, Transition has helped patients achieve more than 60,000 pounds of collective weight loss while making meaningful improvements in their health.

PA Zucchi serves on the board of the New England Obesity Society and as a clinical preceptor for physician associate students at MCPHS University. He is also a national speaker and advisor in obesity medicine, educating healthcare professionals on obesity as a chronic disease, anti-obesity medications, cardiometabolic health, and strategies to improve patient outcomes.

A passionate advocate for people living with obesity, PA Zucchi is actively involved in efforts to improve treatment access, advance obesity care, and challenge the stigma and misconceptions surrounding the disease. He has authored numerous articles and op-eds, appeared on podcasts and professional educational programs, and his expertise has been featured in The Wall Street Journal, The New York Times, Bloomberg, USA Today, Forbes Health, Medscape, The Boston Globe, and other national media.