INS and obesity due to melanocortin 4 receptor deficiency: Long-term outcomes revealed that offspring of women after biliopancreatic diversion had lower overweight and obesity risk reduced to population risk up to 18 years after birth and no increase in underweight, better insulin sensitivity, lipid metabolism and ghrelin levels, lower inflammatory parameters and leptin levels, and less hypertension compared to offspring of nonoperated women [53, 54].