On the other hand, and indirectly, patients with obesity are characterized by an increase in low-grade chronic inflammation associated with mitochondrial dysfunction, an increase in oxidative stress and the suppression of the anabolic action of insulin-like growth factor-1 (IGF-1) [94,95,96,97], therefore facilitating SO [98]. Here, IGF1 is linked to obesity due to melanocortin 4 receptor deficiency.