1st March 2024

A 24-year-old male has been managed by his GP for his ongoing obesity

A 24-year-old male has been managed by his GP for his ongoing obesity. It has been a struggle to manage his weight with dietary measures due to his behavioural issues, where he experiences anger outbursts when he cannot access food. His parents note that he has the urge to eat all day and does not feel full despite a full meal.

On examination, he has a narrow forehead with a prominent narrow nasal bridge and a thin upper lip. He is significantly obese, and this is centrally distributed. He is currently under review from the mental health team for his learning difficulties. He has also been seen by the urology team for bilateral cryptorchidism.

Given the likely underlying diagnosis, which of the following genetic mechanisms has resulted in the clinical presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.