Ghrelin concentrations in morbidly obese patients after adjustable gastric banding.

To the Editor: It has been suggested that the reduction in plasma ghrelin concentrations in five morbidly obese patients after treatment with a proximal Roux-en-Y gastric bypass contributed to the weight-reducing effect of the surgery.1 This hypothesis has been questioned,2 because decreased plasma ghrelin concentrations are present in obese people before any intervention and were documented approximately 1.4 years after gastric bypass surgery, when weight loss of approximately 36 percent had occurred. Bariatric surgery is becoming more common — particularly, laparoscopic adjustable gastric banding. This procedure, which was recently approved by the Food and Drug Administration, causes less dramatic weight . . .