Leptin resistance inobese people leads to increased food intake,and the inability to increase tidal volume andrespiratory rate to cope with the increasedwork of breathing associated with obesity.Hypercapnia in OHS is postulated to be acause of insufficient drive on the respiratorycentre caused by leptin resistance, or lowleptin levels. This evidence concerns the gene LEP and obesity due to melanocortin 4 receptor deficiency.