In this phase 2 trial in participants with obesity and MASLD, once-weekly treatment with the GIP/GLP-1/GCG triple agonist retatrutide resulted in substantial reductions in liver fat, body weight, ASAT and VAT, which were associated with improvements in insulin sensitivity, serum lipids, K-18 and pro-C3. The gene discussed is KRT18; the disease is obesity due to melanocortin 4 receptor deficiency.