This study focuses on weight loss using a special technique called *gastric mucosal ablation* and *endoscopic sleeve gastroplasty* (ESG). Obesity, a condition where there's too much body fat, happens when people eat more calories than they burn. ESG is a procedure that reshapes the stomach to help people eat less. While similar to another surgery called *laparoscopic sleeve gastrectomy* (LSG), ESG doesn't work on the stomach's top part called the fundus, which makes a hormone that increases hunger. This study tests if adding ablation (removal of tissue) in the fundus to ESG helps with weight loss. They want to see if this combined method works well and is safe for patients at True You Weight Loss.

• The study is for adults aged 18-65 years old.
• Participants must have a BMI between 28-55 kg/m².
• Participants should be willing to follow lifelong diet changes.