Remarkably, patient 1 did not benefit from the expected weight loss after bariatric surgery (<50% EWL) and the metabolic abnormalities (hypertension, dyslipidemia, and insulin-requiring type 2 diabetes) remained, despite an important caloric restriction induced by the sleeve gastrectomy, showing that her metabolic phenotype was not only due to an environmental Western lifestyle. This evidence concerns the gene INS and hypertensive disorder.