Although ectopic ASIP most likely promotes obesity primarily via central effects, ectopic ASIP may also contribute to obesity through peripheral effects as described for enhanced insulin secretion in the pancreas, leptin secretion from adipocytes, reduced lipolytic activity in adipocytes or regulation of adipogenic transcription factors22,28 and it may even affect activation of brown AT29. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.