Experimental: VLCKD arm

The VLCKD dietary intervention consists of five phases:~Ketogenic Low-Calorie Period (2 months):~* Phase 1 (30 days - Visits 1-3): Ketogenic diet with low-fat content, 600 kcal/day.~* Phase 2 (15 days - Visit 5): 660 kcal/day.~* Phase 3 (15 days - Visit 5): 730 kcal/day~Low-Calorie Period (2 months):~Phase 4 (30 days - Visits 6-7): Hypocaloric diet with the reintroduction of different foods, 1,050 kcal/day.~\- Phase 5 (30 days - Visits 7-8): 1,400 kcal/day.~During these phases, the patient will receive nutritional supplementation with vitamins, trace elements, and omega-3 fatty acids. Throughout the very low-calorie ketogenic period, the patient will have three interim dietetic consultations (Visits 2-4) and a medical visit (Visit 5). During the low-calorie period, the patient will receive alternating two dietetic consultations (Visits 6 and 7) and one medical visit every 30 days (Visit 8).

Active_comparator: Control LCD arm

The control LCD arm consists of a diet with natural low-calorie foods (1200-1500 kcal/day or a reduction of 500-1000 kcal/day compared to baseline) and a low glycemic index based on the Mediterranean Diet model, following the most recent guidelines on MAFLD/NAFLD. Similar to the VLCKD arm, for the entire duration of the dietetic treatment, the patient will alternately receive dietetic consultations and medical visits.~At the end of the dietary intervention, patients from both study arms will continue with a controlled, low glycemic index diet tailored to the patient's basal metabolic rate (BMR) (estimated with bioimpedance assessment) for an additional six months.~Both study arms will follow a physical activity schedule and will have psychological-motivational support.