Furthermore, a majority of individuals suffering from depression experience sleep disturbances and decreased levels of physical activity, which can contribute to the development of obesity.[34] Leptin, disruption of the gut microbiota, and inflammatory signaling pathways serve as connecting factors in this process.[15] On the other hand, negative emotions about body dissatisfaction in obese patients can lead to depression.[35] There is now more evidence supporting the notion that BMI can lead to depression. This evidence concerns the gene LEP and obesity due to melanocortin 4 receptor deficiency.