As adipose tissues expand in obesity, adipocyte hypertrophy rather than hyperplasia predominates, and the ATME switches from type 2 [anti-inflammatory; e.g., interleukin (IL)-4, IL-10] to type 1 [pro-inflammatory; e.g., tumor necrosis factor (TNF), interferon (IFN)γ, IL-1β, and IL-6] cytokine generation (42, 44, 45). The gene discussed is TNF; the disease is obesity due to melanocortin 4 receptor deficiency.