The Discordant Duet – Ghrelin and IGF-1 in Sarah’s Struggle with Obesity

January 8, 2024by Dr. S. F. Czar0

Case Study:

Sarah, a 35-year-old accountant, has battled with her weight for most of her life. Despite trying various diets and exercising regularly, she finds it challenging to keep the pounds off. Her hunger pangs seem relentless, while satiety feels fleeting. Frustrated and concerned, Sarah seeks medical advice to understand why her internal dialogue of hunger and fullness sounds so discordant.

Medical Evaluation:

  • Blood tests: Sarah’s ghrelin levels are moderately elevated, while her IGF-1 levels are surprisingly low. This suggests a potential imbalance in their regulatory dance.
  • Body composition analysis: Sarah shows higher-than-average visceral fat, a risk factor for metabolic syndrome.
  • Dietary assessment: Sarah admits to occasional stress-induced emotional eating, leading to sugary and processed food choices.
  • Sleep study: Sarah exhibits mild sleep apnea, which can disrupt hormone regulation and increase appetite.


Based on the evidence, Sarah likely has a dysregulation in the ghrelin-IGF-1 axis contributing to her obesity. The elevated ghrelin fuels her hunger, while the low IGF-1 hinders satiety signals, creating a perfect storm for overeating. Additionally, stress, poor sleep, and unhealthy food choices exacerbate the problem.

Therapeutic Intervention:

  • Lifestyle modifications: Sarah starts with moderate caloric restriction focusing on whole foods and balanced meals. Regular exercise and stress management techniques like mindfulness meditation are encouraged.
  • Sleep apnea treatment: Addressing her sleep apnea with a continuous positive airway pressure (CPAP) machine should regulate hormone production and improve overall health.
  • Nutritional counseling: Sarah works with a nutritionist to identify and address emotional eating triggers and develop healthier coping mechanisms.
  • Ghrelin-targeted therapy (optional): Depending on Sarah’s progress and medical evaluation, medications that mimic IGF-1’s satiety-inducing effects could be considered.

Over six months, Sarah starts experiencing notable changes. Her hunger pangs lessen, satiety kicks in earlier, and she loses weight steadily. Her mental well-being improves with better sleep and stress management. Blood tests show decreased ghrelin and increasing IGF-1 levels, indicating a restored balance.

Key Takeaways:

  • Sarah’s case illustrates the complex interplay between ghrelin, IGF-1, and various contributing factors in obesity.
  • A holistic approach addressing diet, exercise, sleep, and stress can restore the ghrelin-IGF-1 duet and promote satiety.
  • Personalized therapy focusing on the underlying reasons for hormonal imbalances can lead to sustainable weight management and improved well-being.

Sarah, a 32-year-old accountant, always struggled with social interactions

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