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

Who May Qualify: - 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 willing to sign a consent form on the Institutional review board (IRB) approved willing to sign a consent form form - Patients willing and able to comply with study requirements for follow-up Who Should NOT Join This Trial: - Patients who are treated with intragastric balloons - Family history of esophageal, gastric, or duodenal malignancy and active gastric ulceration, - Pre-existing esophageal stenosis/stricture preventing the advancement of an endoscope 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, and pregnancy/lactation - Evidence of end-stage liver disease, including portal hypertension, ascites, and coagulopathy - Positivity for hepatitis B virus or hepatitis C virus, current alcohol consumption of more than 20 g/day in females and more than 30 g/day in males on average, use of medications with reported hepato-steatogenic effect (amiodarone, tamoxifen, estrogens), and drug-induced liver disease - Type 1 diabetes, Prior bariatric surgery, Autoimmune liver disease (antinuclear antibody titer \>1/160), Wilson's disease, hemochromatosis, alpha1-antitrypsin deficiency, - Known positivity for human weakened immune system virus, a concomitant disease with reduced life expectancy, severe psychiatric condition, drug dependence, or inability to provide willing to sign a consent form. - The patient refuses or is unable to provide written willing to sign a consent form - Prior bariatric treatment procedure Always talk to your doctor about whether this trial is right for you.