If the fundus of the stomach (the primary ghrelin-producing region) is surgically removed, which short-term and longer-term changes in appetite hormones and behavior would you predict?

• A. No change in appetite because ghrelin is not involved in hunger signaling; hunger is regulated only by central neurotransmitters independent of stomach-derived peptides.
• B. Massive long-term increase in leptin secretion from adipose tissue to replace ghrelin's function and fully normalize feeding behavior within hours after surgery.
• C. Immediate and permanent hyperphagia because ghrelin normally suppresses appetite, so removing its source removes inhibition of feeding.
• D. Short-term reduction in preprandial ghrelin peaks and decreased meal-initiating hunger; longer-term, compensatory mechanisms (e.g., altered vagal sensitivity or other gut peptide adjustments) may partially restore appetite.

Answer: (D)