Increased leptin and leptin receptor (ObR) levels and decreased APN levels were reported in obese patients with GERD [129,130,131,132], and increased leptin levels, widely considered as a marker of obesity, have been associated with frequent GERD symptoms [133] and clinical and endoscopic severity of GERD [130]. Here, LEPR is linked to obesity due to melanocortin 4 receptor deficiency.