Upregulated proinflammatory cytokines in patients with obesity may also induce osteopenia and osteoporosis by regulating the receptor activator of nuclear factor kappa-B (RANK)/RANK ligand/osteoprotegerin pathway, with a resulting decreased expression of osteoprotegerin and increased RANK signaling, culminating in osteoclastogenesis activation and bone resorption [10,83]. Here, TNFRSF11B is linked to obesity due to melanocortin 4 receptor deficiency.