GPT and obesity due to melanocortin 4 receptor deficiency: In a systematic review and meta-analysis, among 175 patients with obesity and MASLD treated with ESG, 12-month follow-up showed significant reductions in hepatic steatosis index (−4.85; 95% CI −6.02 to −3.67), NAFLD fibrosis score (−0.50; 95% CI −0.80 to −0.19), and ALT (−6.32 U/L; 95% CI −9.52 to −3.11).