Spurious pleiotropy is another possibility; however there are consistent effects of CADM2 on psychological and obesity traits in a number of cohorts with different recruitment and study designs (population-based, CVD case-control, high CVD risk) and populations (European, UK, north American, Pakistan), which would be expected to differ in their biases. Here, CADM2 is linked to obesity due to melanocortin 4 receptor deficiency.