Chronic low-grade activation of the inflammatory system is a common feature of obesity and is associated with increased secretion of pro-inflammatory cytokine, such as IL-1, IL-6 and tumor necrosis factor, that trigger stimulation of HPA axis by the adipocytes, thereby increasing cortisol release in order to limit the inflammation reaction (24). This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.