Taken together, our data support a model whereby CTCF regulates differential fat distribution in women with upper vs. lower body obesity by: (1) binding more genes in pear-shaped ADSCs, (2) targeting the active promoter region of those same genes, and (3) potentially recruiting or influencing RNAPII activity at these genomic regions. The gene discussed is CTCF; the disease is obesity due to melanocortin 4 receptor deficiency.