Circulating levels of ANGPTL6 are elevated in T2D subjects (16) and correlate with insulin resistance (17); therefore, it was surprising that there was no difference between surgical and non-surgical comparator-subjects-with-obesity; however, this may have been a result of not achieving a lower BMI in the surgical group. Here, ANGPTL6 is linked to obesity due to melanocortin 4 receptor deficiency.