Relative to cluster 3 obesity, cluster 4 individuals with obesity showed enrichment of the Type-B UPV gene expression signature (Fig. 5a, heat map and rank analysis (UPV-B rank)); reduced NNAT/IGN1 expression (Fig. 5c); increased HDAC-responsive gene expression (Fig. 5c); increased inflammatory and decreased adipogenesis gene expression (Fig. 5a′, gene set 2 and 5); and marked dysregulation of Type-B-specific DMRs (Fig. 5d). The gene discussed is HDAC9; the disease is obesity due to melanocortin 4 receptor deficiency.