Inclusion Criteria:
* Informed consent obtained before performing any research-related action. Research-related procedures include any procedures conducted within the framework of this study, including activities to assess eligibility criteria for participation in the study.
* Body Mass Index (BMI) \> 30 kg/m².
* CAP test result \> 238 dB/m based on steatometry performed no later than 3 months before the patient is included in the study.
* Age 18-70 years at the time of signing the informed consent.
Exclusion Criteria:
* Any contraindication to the appointment of semaglutide.
* Documented reasons for chronic liver disease other than non-alcoholic fatty liver disease (NAFLD).
* Positive test result for HBsAg, HIV antibodies, or positive test result for HCV-RNA.
* Presence of ascites, bleeding from esophageal varices, hepatic encephalopathy, spontaneous bacterial peritonitis, or liver transplantation at the time of screening or a history of these conditions.
* ALT activity \> 5 times the upper limit of normal (ULN).
* AST activity \> 5 times the ULN.
* Alkaline phosphatase activity \> 2 times the ULN at screening.
* International Normalized Ratio (INR) of prothrombin time ≥ 1.35 at screening.
* MELD score \> 12 points at screening.
* Platelet count less than 150,000 per microliter of blood, unless it reflects the patient's usual platelet level, and the patient does not have a diagnosis of portal hypertension in the investigator's opinion.
* Treatment with GLP-1 receptor agonists within 90 days prior to the screening visit.
* Treatment with hypolipidemic drugs or weight loss medications, whose dosage has not been stable, in the investigator's opinion, for 90 days prior to the screening visit.
* Previous or planned (during the study period) treatment of obesity with surgical intervention or the installation of a special device for weight loss. However, the following procedures are allowed:
1. Liposuction and/or abdominoplasty, if performed more than 1 year before screening.
2. Laparoscopic gastric banding, if the band was removed more than 1 year before baseline liver biopsy and screening.
3. Intragastric balloon placement, if the balloon was removed more than 1 year before baseline liver biopsy and screening.
4. Duodenojejunal sleeve bypass, if the sleeve was removed more than 1 year before baseline liver biopsy and screening.
* Presence of malignant neoplasms currently or in history within the last 5 years prior to screening. Exceptions include only basal cell or squamous cell skin cancer and any carcinoma in situ.
* History of acute pancreatitis within 180 days prior to inclusion in the study.
* Presence of chronic pancreatitis currently or in history.
* Any of the following: myocardial infarction, stroke, heart failure of NYHA class IV, hospitalization for unstable angina, or transient ischemic attack within the last 90 days before the screening day.
* Any health disorder that, in the investigator's opinion, could jeopardize patient safety or affect compliance with the protocol requirements.
