Cushing’s Syndrome

Cushing’s syndrome occurs when your body is exposed to high levels of the stress hormone cortisol for a prolonged period. This can cause rapid weight gain, particularly in the face, abdomen, and upper back, along with thinning arms and legs. It may be caused by long-term steroid medication use or, more rarely, a tumour affecting the adrenal or pituitary glands.

Cushing’s syndrome is a disorder of chronic glucocorticoid excess, either exogenous (iatrogenic, from long-term corticosteroid therapy) or endogenous (ACTH-dependent or ACTH-independent). Cortisol excess promotes central adiposity through increased lipogenesis and adipocyte differentiation in visceral depots, while inducing muscle wasting via proteolysis. Characteristic features include moon facies, dorsocervical fat pad, abdominal striae, and proximal myopathy. Diagnosis requires confirmation of hypercortisolism via 24-hour urinary free cortisol, late-night salivary cortisol, or low-dose dexamethasone suppression test.

Weight gain from Cushing’s syndrome does not respond to standard diet and exercise. Identifying the underlying cause is essential for effective treatment. Dr. Joseph Wang includes endocrine evaluation as part of a comprehensive medical approach to unexplained weight gain.