Although instruments for assessing hyperphagia, such as the Dykens Hyperphagia Questionnaire, have reported higher hyperphagia scores in those with obesity associated with LEPR and MC4R variants compared with those with syndromic obesity [30], further investigations are necessary to verify to what extent current questionnaires will be suitable for patients with hyperphagia resulting from rare MC4R pathway–associated diseases [5, 13, 53]. Here, MC4R is linked to obesity due to melanocortin 4 receptor deficiency.