This randomized controlled trial evaluated the effects of a lifestyle intervention on nonalcoholic steatohepatitis (NASH). Thirty-one overweight or obese individuals with biopsy-proven NASH were randomly assigned to an intensive lifestyle intervention group (LS) or a control group. The LS group received a combination of diet, exercise, and behavior modification aimed at achieving a 7-10% weight reduction. After 48 weeks, the LS group lost an average of 9.3% of their body weight, compared to 0.2% in the control group. The LS group also showed significant improvements in NASH histologic activity score (NAS), with a higher proportion of participants achieving a reduction of NAS ≥ 3 points or a post-treatment NAS ≤ 2. The study concluded that weight reduction through lifestyle intervention can lead to improvements in liver histology in NASH patients.This randomized controlled trial evaluated the effects of a lifestyle intervention on nonalcoholic steatohepatitis (NASH). Thirty-one overweight or obese individuals with biopsy-proven NASH were randomly assigned to an intensive lifestyle intervention group (LS) or a control group. The LS group received a combination of diet, exercise, and behavior modification aimed at achieving a 7-10% weight reduction. After 48 weeks, the LS group lost an average of 9.3% of their body weight, compared to 0.2% in the control group. The LS group also showed significant improvements in NASH histologic activity score (NAS), with a higher proportion of participants achieving a reduction of NAS ≥ 3 points or a post-treatment NAS ≤ 2. The study concluded that weight reduction through lifestyle intervention can lead to improvements in liver histology in NASH patients.