While the mechanistic relationship between obesity and pancreatic carcinogenesis is likely multifactorial, activation of oncogenic Kras is observed in more than 90% of precursor pancreatic intraepithelial neoplastic lesions and is widely accepted as the initial step in the malignant transformation of normal pancreatic acinar cells [30]. This evidence concerns the gene KRAS and obesity due to melanocortin 4 receptor deficiency.