GLP1R and obesity due to melanocortin 4 receptor deficiency: While metabolic surgery (MS) has long been proven to be the most effective and durable treatment option for individuals with obesity and obesity related disease [1, 2], the explosion of increasingly effective anti-obesity medication (AOM) classes, namely glucagon-like peptide-1 receptor agonists (GLP-1-RAs) and other enteroendocrine based therapy, have contributed to a flurry of renewed public interest in both the medical and surgical treatment of obesity.