Both unacylated ghrelin and acylated ghrelin have been shown to decrease with obesity and represent positive energy balance (Wang et al., 2022), but as this non‐obese participant had stable body composition and acylated ghrelin levels, our data does not allow us to track the exact physiological mechanism behind this outlier. The gene discussed is GHRL; the disease is obesity due to melanocortin 4 receptor deficiency.