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The procedure works through two mechanisms, not just one: Restriction : The reduced stomach capacity limits meal size and calorie intake Hormonal change : Removing a large portion of the stomach also removes the tissue that produces ghrelin, the primary hunger-stimulating hormone, which is why many patients report significantly reduced appetite beyond just feeling full sooner This hormonal component is what distinguishes sleeve surgery from purely mechanical restriction, and it is why outcomes tend to be more durable than diet alone

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Improvements in these conditions through weight loss may enhance libido, while persistent or worsening symptoms may suppress it