Continuous linear growth, delayed bone maturation, tall stature.  Diffuse bone pain, genu valgum.  Cisgender, heterosexual, normal libido.  Normal testicular volume. Normal serum LH and testosterone, increased FSH levels.  Focal hypospermatogenesis on testicular biopsy.  Obesity, acanthosis nigricans, hepatomegaly. Moderate dyslipidemia, Insulin resistance.  Osteoporosis. Here, PLOD1 is linked to obesity due to melanocortin 4 receptor deficiency.