INS and obesity due to melanocortin 4 receptor deficiency: Sixty-eight studies were excluded after reviewing full texts for the following reasons: (A) six did not measure main outcomes (fasting glucose, fasting insulin, HOMA-IR, or body weight), (B) twenty-eight did not have a control group, (C) ten were performed in children or adolescents without overweight or obesity, (D) two were published more than once, (D) twelve did not include an exercise group, and (E) ten had only post-test data.