The link between obesity and the cardiac NPs originates with reports by Sarzani et al. showing that receptors for ANP and BNP are present in adipose tissue (14) and that obese human subjects often have substantially higher amounts of the NP clearance receptor NPRC in adipose tissue and lower circulating NPs (18, 37). Here, NPPB is linked to obesity due to melanocortin 4 receptor deficiency.