INS and obesity due to melanocortin 4 receptor deficiency: Tobacco affects health mainly via increasing DNA damage and oxidative stress, and smokers with obesity have been shown to be at higher risk of morbidity and premature mortality compared with nonsmokers without obesity.11 The health benefits of a healthy diet and physical activity include reduced insulin resistance, oxidative stress, and inflammation and improvements in lipid lipoprotein profiles.30,31,32