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The response of GH secretion to exogenous ghrelin is significantly blunted in obese patients and this response is restored early on after Roux-en-Y gastric bypass (prior to any major weight loss), suggesting that there is an intrinsic resistance to ghrelin in obesity which is reversed with gastric bypass, and which is not linked to weight loss (525)

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Increased PAG activity has been associated with reduced baroreflex sensitivity and enhanced sympathetic tone, thereby facilitating adaptive responses to cognitive and emotional challenges

ScienceDirect , doi:10.1016/j.neubiorev.2015.04.015