Studies show that IR is the root cause of obesity because it causes hyperinsulinemia, which stimulates steroid synthesis from the ovary and adipose tissue, which in turn reduces the hepatic secretion of sex hormone-binding globulin, causing free androgens to rise, which, if increased chronically, can lead to central obesity via accumulation of visceral fat, worsening symptoms of PCOS and thus, creating a vicious cycle of complications [33,34]. This evidence concerns the gene SHBG and polycystic ovary syndrome.