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Ghrelin. The Key to Weight Loss?

Ghrelin is a hormone produced, in part, by the fundus in upper part of the pre-bariatric surgery stomach. It is of particular interest because it is known to regulate hunger. Theoretically, if you remove the production of the hunger hormone, a patient will be less hungry and lose weight as a result. In practice, not all patients get that benefit, but many do. There is some research to suggest that ghrelin may also affect sleep patterns and depression, both of which in turn can affect weight. While this seems like a relatively simple solution to obesity, it still requires other considerations – making it a bit more complex.

Firstly, not all of the ghrelin is eliminated from the body when the fundus is removed. There are other areas of the body that procedure this hormone including the brain, pancreas and small intestine. That said, the majority of the hormone’s production is stopped after certain bariatric surgeries.

Secondly, in order to eliminate the fundus, some sort of restrictive bariatric surgery must be performed. This is where the gastric sleeve helps. During the gastric sleeve procedure, 80% of the stomach is cut away and removed from the abdomen. With this removal comes the reduction of stomach size, the elimination of the stomach’s fundus and with it, much of the body’s production of ghrelin. The sleeve is the only major procedure that actually removes the fundus from the body.

Thirdly, not all patients who may be overweight or obese are suitable candidates for major abdominal surgery. This is especially true for patients whose excess weight may not be causing them significant medical issues beyond any aesthetics. Further, those with significant scar tissue and those who are not able to safely undergo surgery due to health concerns may not qualify.

Data and clinical testing on the effect of ghrelin on weight loss is still in its infancy but a suppression of hunger is a point to be explored. It is also part of the reason behind the gastric sleeve’s ever-increasing popularity in the United States. But is everyone suited to the gastric sleeve? The short answer is no. Some patients, especially those with significant or uncontrolled gastroesophageal reflux disease or GERD and those with significant or poorly controlled type 2 diabetes may benefit from a gastric bypass. The best way to find out is by calling our office and scheduling a consultation with Dr. Duncan.

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