ACE and obesity due to melanocortin 4 receptor deficiency: Adiposity (overweight and obesity) is a powerful risk factor for cardiovascular disease (CVD) [1], and is recognized in recent obesity screening and treatment guidelines for both adults [2] and children [3,4] Adipocytes secrete fatty acids, express renin-angiotensin system components (e.g. angiotensin converting enzymes), and release inflammatory factors which advance atherosclerosis by respectively promoting hyperlipidemia and insulin resistance, high blood pressure, and vascular inflammation [5].