From the Research
Bariatric surgery can be a viable option for weight loss in patients with congenital adrenal hyperplasia (CAH), but it requires careful consideration and specialized management, as evidenced by a recent case report in 2025 1.
Key Considerations
- Patients with CAH who have obesity that hasn't responded to conventional weight loss methods may benefit from bariatric procedures such as gastric bypass, sleeve gastrectomy, or adjustable gastric banding.
- A multidisciplinary team including an endocrinologist familiar with CAH management is necessary for comprehensive pre-surgical evaluation.
- The underlying hormonal imbalances in CAH, particularly excess cortisol and androgen production, must be well-controlled before surgery through appropriate glucocorticoid replacement and sometimes mineralocorticoid therapy.
Recent Evidence
- A 2025 case report 1 highlights the potential of an integrative, multidisciplinary approach to address severe obesity and its associated comorbidities in patients with classic congenital adrenal hyperplasia.
- The report suggests that tailored obesity management strategies, including pharmacotherapy with semaglutide and bariatric surgery, can optimize health in this unique population.
Management and Monitoring
- Post-surgery, medication dosages will likely need adjustment as weight loss occurs, and stress-dosing protocols must be established for the perioperative period.
- Patients should be monitored for potential complications including adrenal crisis, nutritional deficiencies, and changes in medication absorption.
- The benefits of bariatric surgery in CAH patients include not only weight reduction but potentially improved hormonal balance and reduced cardiovascular risk factors, though long-term outcome data specific to CAH patients remains limited, as noted in earlier studies 2, 3, 4, 5.