A 90-day L-carnitine therapy in patients with nonalcoholic steatohepatitis and obesity improves clinical symptoms, reduces liver markers (ALT by 3.3 times, AST by 3.0 times), decreases cholestasis markers (γ-glutamyltransferase by 2.2 times, ALP by 2.06 times), and reduces mesenchymal inflammation (thymol test by 3.3 times). Here, GPT is linked to obesity due to melanocortin 4 receptor deficiency.