S.No.

Site (activation of hypothalamus)

Effect

1

Inflammatory pathway

Insulin resistance and leptin resistance

2

Melanocortin 4 receptor (MC4R) resistance

Neuronal circulatory downstream of ARC

3

Leptin resistance

Anorectic action blunted and lowers gluconeogenesis

4

HGP (hepatic glucose production)

Hypothalamic sensing of nutrients blunted