In addition to obesity, type 2 diabetes (T2DM), and alcohol consumption,2,3 genetic risk variants have emerged as key contributors to disease progression,4,5 with patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 and transmembrane 6 superfamily 2 (TM6SF2) rs58542926 being the best investigated variants, next to variants in hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13), membrane-bound O-acyltransferase 7 (MBOAT7), glucokinase regulator protein (GCKR), and serpin family A member 1 (SERPINA1).6 Here, SERPINA1 is linked to obesity due to melanocortin 4 receptor deficiency.