We observed stronger risk estimates among obese individuals compared with those without obesity across all quartiles of PRAL (HR: 1.36, 95% CI: 1.11–1.67, Ptrend = 0.0103) and NEAP (HR: 1.33, 95% CI: 1.08–1.63, Ptrend = 0.0150) scores. The gene discussed is PRAL; the disease is obesity due to melanocortin 4 receptor deficiency.