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Cell 177 , 597607 (2019)

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Often nicknamed "the hunger hormone," ghrelin is secreted by an empty stomach and travels directly to the brain to signal that it is time to eat

Although DSM-5 diagnosis is defined through multiple behavioral criteria encompassing impaired control, social dysfunction, continued use despite harm, and tolerance or withdrawal, converging clinical and preclinical evidence indicates that the core pathological feature of SUDs is the progressive loss of control over intake (O'Brien, 2005)