Khat, a term used for the leaves and buds of the plant Catha edulis, is chewed as a cultural tradition in countries of East Africa and the Arabian Peninsula. Habitual khat use is associated with several adverse health effects. Among these effects suppression of appetite is one. Serum levels of some hormones related to appetite regulation were measured in habitual khat chewers. While insulin, c–peptide, T3, T4 and TSH were found to be within normal range, leptin and ghrelin levels were found to be significantly higher than controls. The observation of increased ghrelin levels is normal as the ghrelin level is associated with the fasting state. As the khat chewers have suppressed appetite, their empty stomach triggers the release of increased ghrelin. That, this increased ghrelin level does not cause hunger, may be due to the increased leptin level which keeps appetite suppressed. There seems to be a reversal of the normal reciprocal relationship between ghrelin and leptin levels and the appetite suppressing action of leptin predominates over the appetite stimulating action of ghrelin. Thus it appears that the antagonism to leptin effects by ghrelin may be deranged at the hypothalamus level in khat chewers. It appears that the active principles in khat may cause nervous and hormonal dysregulation of appetite.