The endocrine abnormalities and chronic inflammation observed in PCOS, represented by increased inflammatory markers (e.g. C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) (Aboeldalyl et al., 2021), are not only associated with metabolic derangements, such as obesity and insulin resistance (IR) (Escobar-Morreale, 2018), but also elevate the risk of mood disorders (MDs), which have been shown to be 4–5 times more common in women with PCOS compared to other women (Cooney et al., 2017; Karjula et al., 2017, 2021; Kolhe et al., 2022). Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.