GHRL and major depressive disorder: In contrast, in Prader–Willi syndrome, a rare genetic disorder characterized by multiple symptoms including severe binge-eating, growth retardation as well as learning disabilities, anxiety and depression, hyperghrelinemia correlates positively with hyperphagia (48, 49) and is mostly due to an increase in acyl ghrelin levels whereas desacyl ghrelin and obestatin are unchanged (50, 51).