Her sister (patient B) presented at age 3 years with a similar clinical picture: primary hypocortisolism (serum cortisol < 28 nmol/L) with high plasma ACTH levels (1036 pmol/L), early-onset obesity (at age 3 her weight and height were > 2 SDs above the average, at age 16 her body mass index was 30.3) and hyperphagia, but also an autism spectrum disorder and mild cognitive impairment. Here, POMC is linked to Obesity.