INS and obesity due to melanocortin 4 receptor deficiency: Although we have shown that subjective PNMS from the ice storm predicts many behavioral outcomes such as anxiety, depression, and aggression in the children [18], objective PNMS in Project Ice Storm has been shown to be more important than the mothers' subjective distress levels in predicting cognitive outcomes such as IQ and language throughout childhood [22], [44], physical outcomes such as obesity at age 51⁄2 [45], and insulin secretion at age 13 [46].