INS and obesity due to melanocortin 4 receptor deficiency: Inflammatory cytokines, such as TNF-a, IL-6 and IL-1 could induce appetite, by increasing fat deposition and energy intake.35 Also, in chronic inflammatory condition, adiposity signals including insulin and leptin stimulate the peripheral sympathetic nervous system, which subsequently induces b-adrenegic desensitisation, resulting in an increase in body fat.5 36 Another potential explanation is that excess intake of some nutrients can trigger inflammation in hypothalamus, as a potential cause of obesity.9