The testing for genetic causes of chylomicronemia in LPL, APOC2, APOA5, LMF1, and GPIHBP1 revealed a homozygous variant, c.553G > T, p.Gly185Cy in APOA5, which is associated with hypertriglyceridemia (6), and a heterozygous common variant, c.41G > T, p.Cys14Phe, in GPIHBP1. A diagnosis of polygenic or multifactorial chylomicronemia precipitated by excessive alcohol, obesity, and poor diet was made. The gene discussed is APOA5; the disease is obesity due to melanocortin 4 receptor deficiency.