Repeat analysis of our obesity cases stratified by the presence/absence of developmental delay demonstrated a very strong association of a burden of PHIP very rare LOF variants with obesity in the presence of developmental delay (ORLOF_stage1+2 = 95.01, CI95 = 5.11,1765.21, pLOF_stage1+2 = 3.19 × 10−10; Figure 2). Here, PHIP is linked to obesity due to melanocortin 4 receptor deficiency.