GLP1R and obesity due to melanocortin 4 receptor deficiency: Tirzepatide is the first-of-class dual glucose-dependent insulinotropic polypeptide (GIP)—GLP-1 receptor agonist, which include the satiety effects of GLP-1 signaling together with the effects of glucagon increasing energy expenditure leading to potentially greater weight loss than GLP-1 agonism alone [10], The SURMOUNT-1 trial recently demonstrated the efficacy of once weekly tirzepatide in adults who are overweight or with obesity to result in up to 20.9% reductions in body weight with 15 mg dosages [11].