TNF and obesity due to melanocortin 4 receptor deficiency: Obesity, particularly visceral, is strongly associated with dysregulated expression of inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and IL-6, as well as adiponectin and leptin, contributing to metabolic derangement and insulin resistance (13, 18, 20).