TNF and obesity due to melanocortin 4 receptor deficiency: This was consistent with a longer (1 year) trial of a multidisciplinary weight reduction program in women with obesity which reported a modest weight loss and significant reductions in TNF-α and IL-6 as well as significant correlations between sustained weight loss and reductions in cytokines levels, adhesin concentrations and the improvement of vascular responses to l-arginine [32].