NAD+ and SIRT1 have been reported to suppress inflammation in various diseases such as in autoimmune encephalomyelitis (EAE) [59], liver ischemia-reperfusion injury [39], high-fat-diet obesity [60], etc. It is reported that SIRT1 can reduce pro-inflammatory responses by deacetylating the p65 subunit of nuclear factor kappa B (NF-κB) [61] The NAD biosynthesis pathways regulates the macrophages and act as the metabolic switch that determine the immune responses under specific settings [62, 63]. This evidence concerns the gene SIRT1 and obesity due to melanocortin 4 receptor deficiency.