INS and obesity due to melanocortin 4 receptor deficiency: The greater weight loss among younger patients and those without obesity-related comorbidities is in-line with previous studies [5, 7, 9] and may be related to other factors, such as mobility, covariation with other risk factors (such as comorbid disease and age), and established insulin resistance with higher circulating insulin levels, as well as to the effects of medication on weight gain.