MC4R and obesity due to melanocortin 4 receptor deficiency: Setmelanotide, a highly selective MC4R agonist with a preferential Gqα/G11α pathway stimulation, is approved for specific causes of monogenic obesity upstream of the MC4R (pro-opiomelanocortin deficiency, proprotein convertase subtilisin/kexin type 1, leptin receptor deficiency) (9).