TNF and obesity due to melanocortin 4 receptor deficiency: Chronic inflammation, marked by raised serum interleukin 6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-α), anemia and lower hematocrit levels, immune activation, as well as obesity and other comorbidities have also been defined as etiologies of frailty [5,6].