INS and obesity due to melanocortin 4 receptor deficiency: We recommend future studies to investigate the associations between anxiety/depression and HRQoL in a prospective design with a follow-up period longer than three months, and to include more potential determinants besides social demographics, such as timing of anxiety/depression onset, obesity, insulin therapy and lifestyle factors36, and explore their effects in marginal models (e.g. Generalized Estimating Equations) or conditional models (e.g. Generalized Linear Mixed Models)55 to optimize and test future preventive measures.