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In a study of colon cancer cells, COX-2 expression and PGE2 synthesis were upregulated by the IGF-2/IGF-1R autocrine pathway and IGF-1R blockade decreased COX-2 activity and inhibited tumor cell proliferation and promoted apoptosis (103)

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Metabolic dysfunction is what happens to lead to excess fat it could be decreased leptin (the satiety hormone), insulin resistance, or any number of hormonal imbalances

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It is particularly relevant for individuals combining structured nutrition and physical activity, as it complements metabolic processes already activated by lifestyle habits

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