The Role of Endoscopic Bariatric Treatments in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, closely linked to obesity and metabolic syndrome, and characterized by hepatic steatosis, inflammation, and fibrosis. While lifestyle modifications and bariatric surgery for weight loss have been the cornerstones of treatment, endoscopic bariatric therapies (EBTs) have emerged as minimally invasive alternatives that offer meaningful weight loss and metabolic improvements, potentially benefiting patients with MASLD. Current evidence indicates that EBTs can significantly reduce liver steatosis, improve liver biochemistry markers, and enhance overall metabolic health. This review aims to evaluate the current evidence on the efficacy, safety, and potential role of EBTs in the management of MASLD, highlighting their impact on liver-related outcomes and metabolic parameters. A comprehensive literature review was conducted using PubMed, identifying observational studies, systematic reviews, meta-analyses, and retrospective and prospective trials that examine the effects of EBTs on metabolic markers and liver disease. This review underscores the potential of EBTs as therapeutic options for MASLD, particularly for patients who are unable to achieve sufficient weight loss through lifestyle interventions alone. While current evidence supports their potential role, further large-scale, long-term studies are needed to establish their efficacy in altering long-term disease progression and to define their place in clinical management algorithms.