| Photo courtesy of Myongji Hospital |
[라포르시안] In modern society, obesity is one of the concerns of many people. In particular, over the past two years, the rate of obesity has risen sharply as the use of outdoor activities and sports facilities has been restricted due to COVID-19, and the time spent at home, such as telecommuting and distance learning, has increased.
According to the ‘People’s Quality of Life 2021 Report’ released by the National Statistical Office, the obesity rate in 2020, when the Corona 19 spread, was 38.3%, an increase of 4.5% from the previous year. As a result, home workouts at home and meal kits for diet control are in vogue, and they are continuing their efforts to lose weight in their own way.
However, there are people who do not lose weight no matter how much they diet, such as sufficient exercise and diet. If there is no change in body weight even after a certain period of diet effort, Cushing Syndrome, an endocrine system disease, should be suspected.
Cushing’s syndrome is an endocrine disease caused by excessive exposure to cortisol (glucocorticoid), a steroid hormone secreted by the adrenal glands. Cortisol is secreted when you are stressed and plays a role in stabilizing the body, but if it is excessive, it causes diseases such as obesity, diabetes, and high blood pressure.
Most of the causes of Cushing’s syndrome are exogenous factors that can be found outside the body, and they occur mainly when an overdose of steroid-based drugs. Conversely, there are intrinsic factors that occur as a result of diseases in the body, such as a tumor formed in the adrenal gland or adrenocorticotropic hormone (ACTH) secreted from the pituitary gland, which promotes the production of cortisol.
Patients with Cushing’s syndrome have a round face like a moon, and excessive fat accumulation in the neck and shoulders. In particular, there are many ‘spider-shaped body types (central obesity)’ where fat is concentrated in the abdomen and the arms and legs are relatively thin.
For this reason, it is often confused with obesity and long-term diet plans such as exercise and diet to lose weight, but this can delay the treatment time and cause complications. Typical complications include high blood pressure, elevated blood sugar, osteoporosis, muscle weakness, menstrual irregularity, sexual dysfunction, acne, flushing, and emotional anxiety. If you do not lose weight even after trying to lose weight for more than 3 months, it is better to go to a hospital and get a test.
Diagnosis of Cushing’s syndrome starts with checking the presence of large amounts of cortisol in the body through blood and urine tests. A blood test can be diagnosed when the secretion of steroid hormones is not suppressed with a dexamethasone suppression test. If these tests make a diagnosis suspected of Cushing’s syndrome, CT or MRI scans are used to find the detailed cause.
The weight or fat gain caused by Cushing’s syndrome cannot be controlled with exercise or diet, and must be resolved by finding and treating the cause. Treatment involves surgical removal of a lump in the adrenal gland that causes hormonal imbalance, or if a drug is the cause, the drug is gradually reduced and eventually stopped.
If surgical treatment is difficult, medication and radiation therapy are administered, and regular management is important because there are cases of recurrence even when fully cured.
Professor Lee Min-kyung of the Department of Endocrinology at Myongji Hospital said, “Cushing syndrome is somewhat different from obesity, but it is difficult to detect because its shape is similar, and it is true that few people are aware of it. This can increase, so if there is no change in weight despite sudden weight gain or long-term dieting efforts, you should see a doctor.”
