The Fulness Trial (Fundus mUcosaL abLation aNd Endoscopic Sleeve Gastroplasty)

Inclusion Criteria: * 1\. Male or females patients in the range of class Class I to Class II obesity (30 ≤ BMI ≤ 39.9). * Age between 18 and 65 years (both inclusive). * Treatment naïve for bariatric surgery or endoscopic bariatric therapy. * Patients that have been evaluated by the local MDT and have indication to ESG. * Willingness to comply with the substantial behavioral modifications program as required by the procedure. * Agree to avoid any use of weight loss medications such as Meridia, Saxenda, Januvia, Xenical, or over the counter weight loss medications or supplements throughout the study. * Women of childbearing potential should have negative urine beta human chorionic gonadotropin (hCG) pregnancy test and must agree to use acceptable contraception methods throughout the study duration. * Able to comply with study requirements and understand and sign the Informed Consent Form. Exclusion Criteria: * Previous upper GI surgery (except uncomplicated cholecystectomy or appendectomy), or other endoscopic bariatric procedures or conditions, * Prior intra-gastric balloon or another gastric implant. * History of a structural or functional disorder of the esophagus or pharynx that may impede passage of the device such as achalasia, stricture/stenosis, esophageal varices, esophageal diverticula, esophageal perforation, severe or intractable gastro-esophageal reflux symptoms while on maximal medical therapy, uncontrolled GERD defined as LA grade C esophagitis or greater. * History of a structural or functional disorder of the stomach including gastric polyps \> 1 cm in size, gastroparesis, gastric ulcer, gastric cancer, chronic gastritis, gastric varices, hiatal hernia (\>4 cm) of axial displacement of the z-line above the diaphragm. * Active H. pylori infection (subjects with active H. pylori may continue with the screening process if they are treated with an appropriate antibiotic regimen, and eradication has been confirmed). * Patients with history of intestinal stricture/stenosis, small bowel or colonic obstruction or any other obstructive disorder of the GI tract such as adhesive peritonitis and/or abdominal adhesions. * Patients with any inflammatory disease (IBD). * Autoimmune disease, including but not limited to celiac disease, or pre-existing symptoms of systemic lupus erythematosus, scleroderma or other autoimmune connective tissue disorder. * Active hepatitis, active liver disease, hepatic insufficiency , or cirrhosis. * Untreated/inadequately treated hypothyroidism, defined as an elevated Thyroid-Stimulating Hormone (TSH) level at Screening; if on thyroid hormone replacement therapy, must be on stable dose for at least 6 weeks prior to Screening. * Patients with PCOS (hormonal dis-balances). * Persistent Anemia, defined as Hemoglobin \<10 g/dL. * Significant cardiovascular disease including known history of valvular disease, or myocardial infarction, heart failure, transient ischemic attack or stroke within the last 6 months. * Moderate or severe chronic kidney disease (CKD), with estimated glomerular filtration rate (eGFR) \<45 ml/min/1.73m2 (estimated by MDRD). * Known immunocompromised status, including but not limited to individuals who have undergone organ transplantation, chemotherapy or radiotherapy within the past 12 months, who have clinically-significant leukopenia, who are positive for the human immunodeficiency virus (HIV) or whose immune status makes the subject a poor candidate for clinical trial participation in the opinion of the Investigator. * HbA1c \> 8.5 %. * Patients requiring exogenous insulin. * Use of glucose-lowering drugs for diabetes mellitus treatment with the exception of sulfonylurea (SU), biguanides and sodium dependent glucose co-transporter 2 (SGLT-2) inhibitors. * Coagulopathy, congenital or acquired intestinal telangiectasia. * Use of systemic glucocorticoids (excluding topical or ophthalmic application or inhaled forms) for more than 10 consecutive days within 90 days prior to the Screening Visit. * Pregnant or breast-feeding woman. * Patients with history or current abuse of drugs or alcohol. * Patients who are taking medications that cause weight loss such as Meridia, Saxenda, Januvia, Xenical, or over the counter weight loss medications or supplements throughout the study. * Patients who are taking medication that cause weight gain such as anti-depressants * Psychiatric or cooperative problems or low compliance that is a contraindication from participating in the study. * Any health issue that might put the patient at risk if the treatment is performed, judged by the investigator.