MC4R and hyperinsulinemic hypoglycemia, familial, 4: A retrospective analysis of a broad population of patients with LEPR, POMC, or MC4R deficiency did report initial weight loss with gastric banding in 2 patients with LEPR deficiency, with sleeve gastrectomy in 1 patient each with LEPR, POMC, and MC4R deficiency, and with gastric bypass in 2 patients with LEPR deficiency and 1 patient with POMC deficiency; critically, severe hyperphagia persisted in all patients after MBS [52].