This study is about a medical procedure to help with weight loss. It's called **gastric mucosal ablation combined with endoscopic sleeve gastroplasty (ESG)**. Obesity is when a person weighs a lot more than is healthy, and it's often caused by eating more calories than the body uses. ESG is like reshaping the stomach without cutting it open. The stomach is made smaller to eat less. In this study, the stomach's upper part, called the **fundus**, is targeted because it makes a hormone named **ghrelin** that makes you feel hungry. The study is looking at how safe and effective this procedure is by collecting information from patients over time.

• The study is for adults between 18-65 years old with a body mass index (BMI) of 28-55 kg/m².
• Participants need to follow a strict diet and agree to use birth control if they are women who can have babies.
• It's not for people with certain mental health issues, pregnant or breastfeeding women, or those with eating disorders.