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Participants underwent\n                      <jats:sup>1<\/jats:sup>\n                      H-magnetic resonance spectroscopy at baseline and at follow-up, along with 2-hour mixed-meal tolerance testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventeen adolescents [baseline mean (standard deviation or SD) BMI = 39.9 (4.1) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; age = 16.0 (1.6) years; 65% male; HFF = 15.6 (5.1)%] demonstrated a mean absolute decrease in BMI of 5.6% [\u22122.23 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95% confidence interval (CI): \u22122.45, \u22122.02;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001] and a 37.3% relative reduction (95% CI: 26.4%, 48.1%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) in HFF. Despite HFF reduction, 13 out of 17 had MASLD at study conclusion. Decrease in HFF corresponded to significant reductions in triglycerides [difference (95% CI): \u22125.8 mg\/dL (\u22129.4, \u22122.1);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012], glucose area under the curve (AUC) [\u22122.2 mg\/dL (\u22123.2, \u22121.3);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.021], and leptin AUC [\u221240.5 pg\/mL (\u221257.1, \u221223.9);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.009]. No significant difference in alanine aminotransferase was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Short-term MRT was associated with reductions in liver fat and improvements in metabolic biomarkers among adolescents with MASLD. Large-scale trials are needed to evaluate the implementation of MRT as part of a multimodal treatment strategy in this population. [Clinical Trial Registration: Enhancing Weight Loss Maintenance with GLP-1 RA (BYDUREON\u2122) in Adolescents With Severe Obesity, NCT02496611,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT02496611\">https:\/\/clinicaltrials.gov\/study\/NCT02496611<\/jats:ext-link>\n                      ].\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21532176261457202","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:08:58Z","timestamp":1781240938000},"page":"389-398","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Meal Replacement Therapy for Metabolic Dysfunction\u2013Associated Steatotic Liver Disease in Adolescents with Severe Obesity"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-9596","authenticated-orcid":false,"given":"John B.","family":"Rode","sequence":"first","affiliation":[{"name":"Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA."},{"name":"Ann &amp; Robert H. 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