MC4R (melanocortin 4 receptor) is a key regulator of appetite and energy balance in the hypothalamus. Loss‑of‑function mutations in MC4R are the most common monogenic cause of severe early‑onset obesity, leading to hyperphagia and reduced satiety. The evidence is strong: carriers of such mutations have a significantly higher risk of obesity. However, these mutations are rare (<1 % of the population). Common variants near MC4R (e.g., rs17782313) have small effects on BMI (~0.2 kg/m² per risk allele). Consumer DNA tests can detect these variants, but the clinical utility for weight loss is limited. Weight management remains primarily driven by diet, exercise, and behavior. MC4R explains only a fraction of weight variability. Direct‑to‑consumer tests often overstate the predictive power. Medical consultation is recommended if a pathogenic variant is found.
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