The gastric X/A-like cell was long thought to be restricted to the production of acyl ghrelin. However, the subsequent years witnessed the discovery of other peptide products derived from this cell, namely desacyl ghrelin, obestatin and nesfatin-1. While the role of obestatin remains highly questionable and is very critically discussed in the literature, besides acyl ghrelin also desacyl ghrelin and nesfatin-1 have been implicated in the regulation of food intake. As observed for several other peptide hormones before, ghrelin and nesfatin-1 are not restricted to one function but rather exert pleiotropic actions including effects on gastrointestinal motility, thermogenesis, lipid and glucose homeostasis, stress mediation, cardiovascular as well as reproductive functions. These often counter-regulatory effects of nesfatin-1 and ghrelin will be discussed in the present review.