LEPR and obesity due to leptin receptor gene deficiency: Successful treatment involves the administration of an exogenous leptin called metreleptin.30 LEPR deficiency is a rare autosomal recessive disorder caused by pathogenic variants of the LEPR gene (LEPR).39 Although rare, it is observed to be more prevalent in Europe according to the available literature.39 While the symptoms of LEPR deficiency are similar to those observed for LEP deficiency, the treatment differs.39 Moreover, LEPR deficiency does not respond to treatment with recombinant leptin therapy.32