PPARG and obesity due to melanocortin 4 receptor deficiency: In addition to the potential development of muscle-intrinsic mitochondrial dysfunction, a systemic consequence of dysregulated PPARG is the development of insulin resistance (IR)24, which is commonly associated with type 2 diabetes, obesity, and metabolic syndrome, and appears to have a bidirectional relationship with BC, with individuals with IR at greater risk of BC and BC survivors at an increased risk of IR25,26.