INS and obesity due to melanocortin 4 receptor deficiency: There are three key pathways through which insulin-lowering diets can reduce tumor volume and metastasis formation: (1) by directly reducing systemic stores of nutrients that are utilized by cancer cells, (2) by altering insulin-related signaling factors which stimulate tumor growth, and (3) by improving obesity-related metabolic parameters such as adiposity, dyslipidemia, and systemic inflammation [32].