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ghrelin lenomorelin hormone enteroendocrine cells gastrointestinal tract stomach hunger meal gastric acid secretion anterior pituitary gland hypothalamic arcuate nucleus neuropeptide neurons appetite growth hormone secretagogue ghsr-1a memory sleep-wake cycle taste sensation reward behavior glucose metabolism ghs-r energy homeostasis cholinergic–dopaminergic link ghrelin receptor obesity cachexia weight vertical-sleeve gastrectomy bypass surgery rendering hormonal therapy replacement function action endocrine endocrinology level prohormone analogue metabolite biosynthesis intermediate