A recent RCT (n=46) of participants with prediabetes and overweight or obesity showed that an ILED every other day for 12 months produced greater reductions (P<.05) in fasting insulin −52% (SE 9%) and insulin resistance -53% (SE 9%) compared with isocaloric daily moderate calorie restriction (−14%, SE 9%; −17%, SE 11%) despite similar decreases in body weight [26]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.