Given this background, this study aimed to investigate the adiponectin/leptin ratio in women with severe obesity with and without MetS before and after RYGB and to characterize the biochemical markers, such as circulating levels of glucose, total cholesterol, high-density lipoprotein (HDL), non-HDL total cholesterol, low-density lipoprotein (LDL), adiponectin, and leptin. Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.