TNF and obesity due to melanocortin 4 receptor deficiency: The role that pro-inflammatory cytokines play in obesity, i.e., TNF-α, IL-6, IL-1, and leptin (23) and the concomitant decrease in the pro-inflammatory cytokine, adiponectin (24) may play in esophageal contractility and increased incidence of esophagitis is unclear as is their role in gastric motility, gastritis, small and large bowel function in obesity.