Table 3.

Features of pure obesity syndromes.

metabolic
	appetite	energy expenditure	body composition	insulin secretion
leptin	increased	BMR normal	selective fat deposition	mild, consistent with obesity
leptin receptor	increased	BMR normal	selective fat deposition	mild, consistent with obesity
POMC	increased	BMR normal	unknown	unknown
MC4R	increased	BMR normal	excess fat and lean mass	severe, early hyperinsulinaemia

endocrine
	growth	puberty	thyroid	adrenal axis
leptin	normal	hypogonadotropic hypogonadism	central hypothyroidism	normal
leptin receptor	reduced	hypogonadotropic hypogonadism	central hypothyroidism	normal
POMC	increased	normal	? hypothyroidism	ACTH deficiency
MC4R	increased	normal	normal	normal