Among the different categories of patients having a high CVD risk, CERT1 might be used as a decision-making tool in diagnostic stratification and primary prevention in essential obesity and, still more, metabolic syndrome, a topic that to our best knowledge has not been fully investigated so far, despite the well-known limitations associated with the use of the (standard) diagnostic criteria such as those defined by the International Diabetes Federation (IDF) [24]. This evidence concerns the gene CERT1 and obesity due to melanocortin 4 receptor deficiency.