Patients with the high BMI might be under situation with higher mechanical stress on bone, higher compensation by the body to strengthen the bone and/or hormone levels such as insulin, leptin, and estrogen and anti-inflammatory adipokines, and larger “protective” effect of a fat “cushion” to absorb impact, possibly resulted in the protective effects referred to as the obesity paradox. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.