Tesamorelin for Reduction of Liver Fat in Adults With Fatty Liver Disease (Mock Study)

Inclusion Criteria: * Adults age 18 to 75 years, able to provide informed consent. * Evidence of hepatic steatosis consistent with MASLD/NAFLD, defined as MRI-PDFF \>=10% at screening (or equivalent imaging documentation if MRI-PDFF was performed within the prior 8 weeks). * Fibrosis risk compatible with non-cirrhotic disease (e.g., FibroScan liver stiffness below a prespecified threshold and no clinical evidence of portal hypertension). * Stable body weight (+/-5%) for at least 3 months prior to screening. * If on diabetes, lipid-lowering, antihypertensive, or weight-loss medications, regimen is stable for at least 3 months prior to screening and expected to remain stable through week 52. * Willingness and ability to self-administer daily subcutaneous injections (or have a trained caregiver). * For participants of childbearing potential: agreement to use reliable contraception during treatment and for 30 days after the last dose; negative pregnancy test at screening and baseline. Exclusion Criteria: * Significant alcohol consumption consistent with alcohol-associated liver disease (e.g., \>20 g/day for women or \>30 g/day for men for sustained periods). * Other chronic liver diseases (e.g., chronic hepatitis B, chronic hepatitis C with viremia, autoimmune hepatitis, Wilson disease, hemochromatosis, alpha-1 antitrypsin deficiency). * Known cirrhosis or decompensated liver disease; or biopsy-proven stage 4 fibrosis if baseline biopsy is performed. * Poorly controlled diabetes or conditions increasing ocular risk (e.g., HbA1c at or above a protocol threshold; active/untreated diabetic retinopathy). * Use of exogenous growth hormone or GHRH analogs within the past 12 months. * Chronic systemic corticosteroids or chronic use of medications known to induce or worsen steatosis or liver injury (e.g., amiodarone, tamoxifen, methotrexate). * Active malignancy or high risk for recurrence judged unsafe by investigators. * Contraindications to MRI (e.g., certain implanted devices) if MRI-PDFF is required. * Pregnancy or breastfeeding. * Known hypersensitivity to tesamorelin or formulation excipients (e.g., mannitol). * Bariatric surgery within the last 12 months, or planned bariatric surgery during the study period.