SPX and obesity due to melanocortin 4 receptor deficiency: Moreover, considering that the abdominal depot is less thermogenic than the subcutaneous one and that it is widely accepted that visceral AT is metabolically more active than the subcutaneous one and modulates many adipokines in plasma [46,47], we may hypothesize that the beneficial metabolic effect of SPX during obesity, principally in visceral AT, primes to the negative thermogenic regulation in this depot.