Our results regarding normal REE in PHP1a are in line with a recent report in patients with obesity caused by heterozygous pathogenic GNAS variants, where hyperphagia was reported for 11/22 patients and decreased REE compared to prediction equations were found in only 2/6 patients and were hypothesized to be associated with partial thyrotropin resistance (57). The gene discussed is GNAS; the disease is obesity due to melanocortin 4 receptor deficiency.