We hypothesised that the treatment of obesity with a very-low-calorie ketogenic diet (VLCKD) could reduce the enhanced levels of EPO associated to obesity via the action of nutritional ketosis synergistically with its effect on body composition [22] and muscle function [23], as well as the improvement in inflammatory and oxidative stress markers [24]. This evidence concerns the gene EPO and obesity due to melanocortin 4 receptor deficiency.