Additionally, obesity is associated with a state of chronic low-grade inflammation, wherein pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 (IL-1), are upregulated, further exacerbating metabolic dysregulation (14–16). Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.