Of note, with regard to the identified predictors of persistence of depression in our sample, several studies indicate that a higher BMI is associated with more severe mood disorders [41,42] as a result of common pathophysiological processes underlying obesity and depressive illness (e.g., leptin/insulin dysregulation or intestinal microbiome alterations) [43]. Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.