PURPOSE: Ghrelin is mainly secreted from the stomach and plays a role in 
appetite, weight gain, and the promotion of a positive energy balance. The 
levels of ghrelin decrease immediately after gastrectomy. We herein investigated 
the effect of the administration of synthetic ghrelin to treat postoperative 
severe weight loss in a prospective, one-arm clinical trial to develop new 
strategies for weight gain.
METHODS: Ten patients (four distal gastrectomy and six total gastrectomy) 
received ghrelin treatment. Eligibility criteria included patients who underwent 
gastrectomy more than 1 year previously and 15 % body weight loss from the 
preoperative weight or a body mass index under 19. Synthetic human ghrelin 
(3 μg/kg) was administered to the patients twice a day for 1 week. Oral intake 
of calories, appetite [evaluated using the visual analog scale (VAS)], and body 
weight before and during administration of ghrelin were compared.
RESULTS: There was a significant difference in the oral food intake before and 
during treatment (before treatment: 1236 ± 409 kcal vs. during treatment: 
1398 ± 365 kcal, p = 0.039), and the VAS for appetite significantly improved 
with each day of ghrelin administration (p < 0.05). Significant amounts of body 
weight were gained (39.5 ± 6.8 vs. 40.1 ± 6.9, p = 0.037).
CONCLUSIONS: The administration of synthetic ghrelin improved the food intake 
and was effective for treating appetite loss and body weight loss. Synthetic 
ghrelin may be a promising new therapy for severe body weight loss following 
gastrectomy.