In a pilot study of 18 children with obesity (10.8 ± 1.6 years; 63% females; BMI z-score 3 ± 0.4), a mean reduction of BMI z-score of 0.30 was achieved after 16 weeks of combined physical activity and nutritional counseling, which led to a significant mean reduction in the liver transaminase SGPT [63]. This evidence concerns the gene GPT and obesity due to melanocortin 4 receptor deficiency.