TNF and obesity due to melanocortin 4 receptor deficiency: Adipose tissue expansion of both the subcutaneous and the visceral compartment leads to hypoxia-induced hypersecretion of adipocytokines such as tumor necrosis factor (TNF) and interleukin (IL) 6 by the adipocytes as well as by the inflammatory immune cells that accumulate in adipose tissue of individuals with obesity (Fernandez-Real et al., 2001; du Plessis et al., 2015).