PGE2 is the principal prostaglandin produced by visceral adipose tissue including EAT deposit [27], which regulates energy metabolism and, particularly in obesity, contributes to fat-inflammation and obesity-related insulin resistance, through the activation of prostaglandin-endoperoxide synthase 2 (PTGES-2) [32], known also as cyclooxygenase 2. This evidence concerns the gene PTGES2 and obesity due to melanocortin 4 receptor deficiency.