Data from our study demonstrate that: i) a 24-h fast increases hypothalamic SERT availability in lean men, but not in men with obesity; ii) 24 h of fasting does not significantly affect mean thalamic SERT or striatal DAT availability in lean men nor in men with obesity, but with high inter-individual variation in the observed responses; and iii) fasting-induced changes in plasma FFA and insulin levels account for much of the observed variation. The gene discussed is SLC6A4; the disease is obesity due to melanocortin 4 receptor deficiency.