Ghrelin, a 28-amino-acid peptide produced primarily in the stomach but also in the upper small intestine and hypothalamus. Ghrelin acts to stimulate appetite, and its secretion increases before meals and decreases after food is eaten. The pattern of ghrelin secretion is similar when caloric intake is restricted, but the level of secretion is increased. Surgical removal of the stomach and operations for obesity that bypass the stomach result in marked decreases in serum ghrelin concentrations. In addition to its appetite-stimulating (orexigenic) activity, ghrelin contributes to the regulation of energy homeostasis. It may also participate in regulating the secretion of growth hormone by the anterior pituitary gland.