Though incretin mimetics and sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise for MASLD, an unmet need remains for approaches that (a) are liver specific, indicated for patients without diabetes or obesity; (b) limit lifelong high-cost pharmacotherapy; and/or (c) limit toxicities (9, 10). The gene discussed is SLC5A2; the disease is obesity due to melanocortin 4 receptor deficiency.