GHRL and Cachexia: In conclusion, utilization of synthetic GHS-R1a ligands, such as BIM-28163 and BIM-28131 that are powerful stimulators of appetite and act through pathways that are distinct from those activated by ghrelin, even in situations when ghrelin seems modestly effective, can have important clinical implications, in conditions such as cachexia or anorexia [see other chapter in the same issue: Ghrelin: Central and Peripheral Implications in Anorexia Nervosa (Mequinion et al., 2012)].