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Ghrelin and desacyl-ghrelin stimulate hepatic steatosis through the direct activation of hepatocytes upregulating several transcription factors related to hepatic lipogenesis, such as PPAR, SREBF1 or CCAAT/enhancer-binding protein (C/EBP), as well as by upregulating key enzymes involved in triacylglycerol synthesis, such as monoacylglycerol O-acyltransferase 2 (MOGAT2) and diacylglycerol O-acyltransferase 1 (DGAT1) [107,108,109]

Its also noteworthy that many pharmaceutical companies offer patient assistance programs that may help offset the cost of these medications for individuals who dont have insurance or whose insurance does not fully cover the cost