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Humoral factors from adipose tissue or adiposity signals, leptin and insulin, are mostly involved in the long-term regulation of food intake and energy metabolism as dictated by energy needs and the amount of energy stores, and can act on both cell types simultaneously to produce satiety through appetite suppression or hunger when the body is in a negative energy state (hungry) [14,15]

5b and Supplementary Table 3b)

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The effects of not drinking enough water appear in the musculoskeletal system early and in extreme cases, they can trigger a chain reaction that circles back to damage the kidneys

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This leaves open the question that there may be some other primary effect that is yet to be determined, says Ard