IGF1R and obesity due to melanocortin 4 receptor deficiency: However, these reviews did not integrate endocrine–metabolic and inflammatory axes with tissue biomarkers—estrogen receptor (ER)/progesterone receptor (PR) status, progesterone resistance, insulin-like growth factor-1 (IGF-1) and its receptor (IGF1R)—into a single mechanistic-to-intervention framework, nor did they operationalize precision prevention through phenotype-guided pathways for women with obesity.