A Randomized Controlled Study Evaluating Bariatric Surgery as a Treatment for Severe NASH With Advanced Liver Fibrosis in Non-severe Obese Patients

This randomized trial tests whether bariatric (weight loss) surgery — specifically sleeve gastrectomy or gastric bypass — is superior to standard medical treatment for resolving non-alcoholic steatohepatitis (NASH), a serious form of fatty liver disease, in adults with moderate obesity (BMI 30–35 for most patients) who already have advanced liver scarring (fibrosis). NASH can progress to cirrhosis or liver failure, and current medical options are limited. Eligible participants are adults with a BMI of 30 or higher who have confirmed advanced fibrosis (F3 or F4 on liver biopsy or imaging), controlled blood pressure, no prior bariatric surgery, and no decompensated cirrhosis or active cancer. Participation involves liver biopsies at the start and end of the study, either surgery or continued medical management, and follow-up visits over 2 years. This summary was prepared to help patients understand the study in plain language.