This is a laparoscopic procedure that restricts the amount of food a patient can eat. Such procedures are termed ‘restrictive’. To perform a vertical sleeve gastrectomy (VSG), approximately 60% to 70% of the patient’s stomach is removed with very sophisticated and state of the art staples. Research has shown that the amount of the “hunger hormone” ghrelin is greatly reduced after the VSG. The reason behind this is that this hormone is produced in great amounts in the fundus of the stomach, much of which is removed during a VSG (Ghrelin is also produced in the pancreas).