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This relatively modest result likely stems from the limited use of specific terminology such as inadequate DNA repair in PubMed-indexed abstracts

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Gastric sleeve surgery achieves weight loss through multiple mechanisms: it mechanically restricts food intake by reducing stomach volume, removes the fundus (which produces the hunger hormone ghrelin), and alters gut hormone secretion

Distributed under the brand names Geref and Geref Diagnostic, it gained FDA approval in 1997 as a treatment for growth hormone deficiency but was discontinued in 2008 not out of concern for safety or lack of efficacy, but because of manufacturing difficulties.2 3 Yet it remains available in compounded form with a prescription from a licensed healthcare provider