Genetic Effect on Omega 3 Fatty Acids for the Treatment of Fatty Liver Disease

Inclusion Criteria: * 10 to 19 years of age * BMI equal or greater than the 95th percentile for age and gender * Genotype PNPLA3 CC or GG * Liver MRI Hepatic Fat fraction ≥5.5% Exclusion Criteria: * Food allergy to fish or any components of the pills which include alpha tocopherol partially hydrogenated vegetable oils including soybean oils, gelatin, glycerol, corn or iron oxide * Pregnant or breastfeeding * Known bleeding disorder or coagulopathy or treatment with anticoagulant mechanisms or low platelet counts, abnormal PT or PTT * Impaired glucose tolerance, Type 1 or 2 diabetes * Birth control pills * Alcohol consumption * Other liver disease * Taking any medication that alters triglyceride levels, liver function, blood pressure, glucose or lipid metabolism * Taking over the counter supplements that affect triglycerides or lipid metabolism including fish oil supplements * Treatment for or diagnosis of thyroid disorder or have an elevated TSH at baseline * Use of any antipsychotic medication * Taking chronic anti-inflammatory medications * Less than 100 pounds (45 kg)