Obesity-relatedmetabolic dysfunction, chronic inflammation, and increased energyextraction from diet can all be caused by abnormal gut microbiota.141 Due to this dysbiosis, Gram-positive bacteriamay overproduce LTA, which can stimulate the immune system and worsenthe inflammatory response by triggering the release of inflammatorycytokines such as TNF-α and IL-6.142 This immune activation can further contribute to chronic inflammationand insulin resistance (IR), which are hallmark features of obesity-relatedmetabolic dysfunction.143. This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.