Compared to patients who had less severe obesity, those with greater severity of obesity were more likely to be women and younger, with lower N-terminal pro-brain type natriuretic peptide (NTproBNP) levels but more severe impairments in HF symptoms, physical limitations and exercise function as reflected by lower KCCQ-CSS and 6MWD and higher New York Heart Association (NYHA) class and CRP levels (Table 1). This evidence concerns the gene NPPB and obesity due to melanocortin 4 receptor deficiency.