CFD and obesity due to melanocortin 4 receptor deficiency: The inflammatory state in lipedema appears fundamentally different from that in obesity alone, with altered cytokine profiles and dysregulation of immune responses, including a significant downregulation of complement factor D (CFD) [4]. In this context, food-specific IgG may function as a quantitative readout of mucosal antigen exposure and tolerance in disorders with suspected barrier dysfunction, such as lipedema.