Effectiveness of Endoscopic Sleeve Gastroplasty in Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis

Inclusion Criteria:

• Body mass index (BMI) greater than 30 kg/m2, who are eligible for ESG

• Patients scheduled to undergo an endoscopic bariatric weight loss procedure (ESG)

• Patients older than 18 years and younger than 75 years of age at the time of consent

• Patients able to provide written informed consent on the Institutional review board (IRB) approved informed consent form

• Patients willing and able to comply with study requirements for follow-up

Exclusion criteria:

• Patients who are treated with intragastric balloons

• Family history of esophageal, gastric, or duodenal malignancy and active gastriculceration,

• Pre-existing esophageal stenosis/stricture preventing the advancement of anendoscope during screening/baseline Esophagogastroduodenoscopy (EGD)

• Presence of any gastric condition which required endoscopic surveillance (e.g.,known gastric intestinal metaplasia),

• Known vascular abnormalities, obligate therapeutic anticoagulation, andpregnancy/lactation

• Evidence of end-stage liver disease, including portal hypertension, ascites, andcoagulopathy

• Positivity for hepatitis B virus or hepatitis C virus, current alcohol consumptionof more than 20 g/day in females and more than 30 g/day in males on average, use ofmedications with reported hepato-steatogenic effect (amiodarone, tamoxifen,estrogens), and drug-induced liver disease

• Type 1 diabetes, Prior bariatric surgery, Autoimmune liver disease (antinuclearantibody titer >1/160), Wilson's disease, hemochromatosis, alpha1-antitrypsindeficiency,

• Known positivity for human immunodeficiency virus, a concomitant disease withreduced life expectancy, severe psychiatric condition, drug dependence, or inabilityto provide informed consent.

• The patient refuses or is unable to provide written informed consent

• Prior bariatric treatment procedure