Women with higher BMI were found to have increased risk of developing fibroids due to increase in biologically available estrogens; it occurs in two ways as the adipose tissue converts the adrenal and ovarian androgens into estrogens and several obesity related mechanisms lead to decreased synthesis of sex hormone binding globulin thus ultimately resulting in increased growth and prevalence of leiomyomas by estrogens. Here, SHBG is linked to obesity due to melanocortin 4 receptor deficiency.