INS and obesity due to melanocortin 4 receptor deficiency: There are several mechanisms that can explain the association between obesity and EC, including increased incidence of GERD, increased secretion of proinflammatory adipocytokines in the serum, causing insulin and insulin-like growth factor secretion disorder, and leptin (Eusebi et al., 2012; Greer et al., 2012; Mokrowiecka et al., 2012).