INS and obesity due to melanocortin 4 receptor deficiency: Individuals with obesity and NAFLD exhibit high levels of de novo lipogenesis (DNL) in both fasting and postprandial state [33, 34] and the anti-lipolytic effects of insulin are diminished by adipose tissue; that is, the rate of basal lypolysis in adipocytes is increased, which increase the delivery of fatty acids to the liver [35, 36].