HOXB9 and obesity due to melanocortin 4 receptor deficiency: In patients with obesity (BMI ≥ 30 and <35), high ODC1 expression was associated with poorer OS compared to low ODC1 expression (HR = 3.32; p = 0.008) (Supplementary Fig. 9d), while high HOXB9 expression was linked to worse OS than low HOXB9 expression (HR = 3.23; p = 0.007) (Supplementary Fig. 9e), indicating that high HOXB9 and high ODC1 expression in patients with obesity are associated with poor prognosis.