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Why being overweight prevents you from having an adrenal operation

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Adrenal tumors cause weight gain

Weight gain is a common concern for many patients with hormone problems, including those with adrenal tumors. Adrenal tumors frequently cause weight gain and obesity. 

Changes in the body’s fat tissue at a cellular level is caused by the cortisol over-production from the adrenal tumor. The cortisol slows down metabolism and increases appetite. So, not only are you wanting to eat more, but the excess cortisol is causing the fat redistribution and changes within the fat, further promoting weight gain. Weight gain with these adrenal tumors is inevitable. 

Learn more about weight gain and adrenal tumors.

Why being overweight prevents you from having an adrenal operation

In addition, weight gain and obesity sometimes make adrenal surgery very difficult or even not possible at all.

Weight and obesity factor in with all surgery, and especially surgery that involves the abdomen. Especially for inexperienced surgeons, the higher the BMI of the patient the more challenging the operation is. For the Mini Back Scope Adrenalectomy (MBSA) the key information is the distance from the skin to where the adrenal gland is. As you can imagine, the more fat a patient has, the longer the distance is from the skin to the adrenal gland. The further the distance from the skin to the adrenal gland, the less maneuverability, and more torque on the instruments during the operation. 

Losing weight before your adrenal operation

If your BMI is greater than 40, it is a good idea to plan to lose about 10 to 20 pounds before your adrenal operation. Losing some weight before the operation will enable you to get mobile much quicker and recover better. Plus, youare likely to lose even more weight as the adrenal  tumor is gone!

For patients with a BMI greater than 50, special considerations sometimes need to be taken. These patients (if they have Cushing’s syndrome) sometimes benefit from medical treatment before their operation. Occasionally, having bariatric surgery such a sleeve gastrectomy may be beneficial prior to adrenal surgery. It all depends on a number of factors and a personalized, individualized approach is very important for these patients.

Learn more about how weight gain and obesity relates to adrenal surgery.

Weight loss without bariatric surgery

Many patients do not want to undergo bariatric surgery for many reasons. Fortunately, there are now some effective ways to lose weight which do not require surgery. These include the new medications Wegovy, Mounjaro and Saxenda. If you need to lose a significant amount of weight in order to have a safe and successful surgery, these drugs could serve as an alternative to bariatric surgery.

This image provided by Novo Nordisk in January 2023, shows packaging for the company’s Wegovy drug. 

Dr. Jim Norman, a world renowned endocrinologist and our sister surgeon at the Norman Parathyroid Center, recently detailed his experience with a  new “miracle” weight loss drug. Learn more about Wegovy and the top ways this drug aides in weight loss from a leading endocrinologist. 

Additional Resources: 

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Author

Dr. Tobias Carling MD, PhD, FACS

Dr. Carling is the most experienced adrenal surgeon in the United States, and by far the world's most knowledgeable surgeon-scientist when it comes to adrenal gland function and disease, adrenal tumors and cancer, and all forms of adrenal gland surgery. Dr. Carling has more experience with advanced minimally invasive adrenal and endocrine operations than any surgeon in the United States. A fellow of the American College of Surgeons, Dr. Carling is a significant member of both the American Association of Endocrine Surgeons (AAES) and the International Association of Endocrine Surgeons (IAES).