How are gastric sleeve and the ghrelin hormone connected?

You may have heard that with gastric sleeve ghrelin hormone is removed or widely reduced. This hormone is one of the leading actors of gastric sleeve. With gastric sleeve ghrelin hormone removal, we’ll see how patients feel hungry, how the hormone affects people, and how it is removed. In the article, we’ll also inform you if ghrelin comes back after some time following your surgery, despite the overall success of the operation. So, let’s have a closer look at how gastric sleeve and these hormones are actually connected.

What is the ghrelin hormone?

What exactly is this important hormone? Well, it’s in fact an amino acid that your stomach produces. Ghrelin is located at the top of the stomach and by the first part of your small intestine. This amino acid is a hormone known widely as the hunger hormone. It has a key role in increasing your appetite. When your body produces this hormone, it sends signals that go to the brain. This whole process makes you feel the hunger.

Ghrelin concentrations play a very important role in regulating your weight long-term. When the level of hunger hormone is high, you feel more hungry between meals and it happens faster after the last time you ate. This hormone is produced when your stomach is empty. 

How does the ghrelin hormone affect obesity?

First of all, the hunger hormone is not a cause of obesity. Ghrelin levels are generally lower when it comes to people who suffer from excess weight. However, research shows that people who have excess weight are more sensitive to ghrelin. This may be the reason for some harmful habits, such as binge eating, and unhealthy food cravings. It may also cause sudden increase and decrease in insulin levels, leading to weight gain, insulin resistance, or even diabetes. (1)

Ghrelin concentrations have the strongest stimulating effect on the hunger center of all proteins known so far. For this reason, it has been called the hunger hormone. Its elevated level may be one of the factors leading to excessive calorie consumption. (2)

If you are an obese patient, your ghrelin levels make you feel a greater need to eat. You want to consume larger portions of food to feel full. Ghrelin levels increase when you are hungry and then decrease. It depends on how fast your digestive system is. The level of this hormone rises up when you are on an extremely reduced diet or have poorly composed meals.

How a ghrelin hormone removed with gastric sleeve surgery?


There is a part of the stomach where the hunger hormone is produced and is mostly active. During your weight loss surgery, this part of the stomach is removed together with cells that produce the hunger hormone.

Your stomach gets much smaller after gastric sleeve surgery. During the procedure, the most hormonally active part of the stomach, responsible for the production of ghrelin, is removed. Thanks to that after the operation you will eat less because you will experience less appetite and feel much fuller between your meals. This procedure will help you reach your excess weight loss goal and consequently improve your health overall. (3)

How gastric sleeve ghrelin removal will affect me?

Remember that the experiences of every patient can be significantly different. Sleeve gastrectomy patients, after their ghrelin hormone removal, can even barely feel an appetite for many months ahead. On the other hand, there are some patients who don’t notice a significant change in the intensity of hunger immediately after the surgery. 

Ghrelin hormone removal will allow you to make more conscious diet choices in the future. You will lower your consumption and eat in the right amounts, with less appetite. Thus, it helps you lose weight faster and easier.

Some patients however can feel hungry even after a few hours without eating. Physically, you shouldn’t be able to feel that much hunger. If you do, however, that means the reason may be psychological. Therefore ghrelin hormone removal procedure might not bring the expected effects. While on your weight loss journey, you can get help and advice not only from your surgeon and dietitian but also from a psychiatrist. Psychological help is also a part of this process. Therapeutic care should be a service in every respectable clinic treating weight loss surgery problems. 

How to know when you are full after gastric sleeve if ghrelin is removed?

It is actually not very difficult to feel full. The hunger hormone removal procedure leads to feeling hungry only when you in fact need food. With small amounts of food, the ghrelin hormone is going to decrease and then will send a message to the brain, and finally, you’ll know you’re full!

Patients after sleeve gastrectomy have less appetite. Their feeling of satiety comes earlier and lasts longer. The level of ghrelin in the blood significantly decreases after gastric sleeve surgery. This decrease is visible from the first postoperative day and lasts even up to two years after the surgery. The way you feel full after your operation is going to be different from people who didn’t get their gastric sleeve surgery.

Typically this will decrease and become more controllable. With passing time you will learn how to adapt to all the changes. However, if there are any persistent or excessive symptoms that worry you, definitely contact your doctor and share your doubts.

Does ghrelin come back after gastric sleeve?

Ghrelin hormone can grow back after the period of two years following your gastric sleeve surgery. So, keep in mind that rising levels of ghrelin might in theory happen during your long-term weight loss journey. Fortunately, during your post-op diet process, your body will learn what to consume and how much food you actually need. So, don’t worry – a ghrelin hormone increase does not directly mean regaining all the weight you’ve lost several months after surgery. 


(1) Fried M, Ribaric G, Buchwald JN, Svacina S, Dolezalova K, Scopinaro N. Metabolic surgery for the treatment of type 2 diabetes in patients with BMI <35 kg/m2: an integrative review of early studies. Obes Surg. 2010 Jun;20(6):776-90. doi: 10.1007/s11695-010-0113-3. PMID: 20333558 link

(2) Jastrzębska-Mierzyńska M, Ostrowska L, Hady HR, Dadan J. Assessment of dietary habits, nutritional status and blood biochemical parameters in patients prepared for bariatric surgery: a preliminary study. Wideochir Inne Tech Maloinwazyjne. 2012 Aug;7(3):156-65. doi: 10.5114/wiitm.2011.27581. Epub 2012 May 29. PMID: 23256020; PMCID: PMC3516993

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top