IGF1 and obesity due to melanocortin 4 receptor deficiency: GH deficiency, which was also noted in this case, is associated with NAFLD/NASH,[14] and clinical application of GH and insulin-like growth factor 1 for obesity and liver cirrhosis were trialed in several pilot clinical studies.[15,16] Additionally, a randomized study demonstrated that GH administration significantly improved the prognosis of patients with chronic liver failure.[17] In our case, although GH supplementation was attempted for 1 year when the patient was 17 years old, the efficacy was unclear.