Obesity in Classic Congenital Adrenal Hyperplasia: Mechanisms, Complications and Management

Classic congenital adrenal hyperplasia (CCAH) is an autosomal recessive genetic disorder primarily caused by 21-hydroxylase deficiency. Although the survival rate of patients has significantly improved with glucocorticoid replacement therapy, long-term use of supraphysiological doses and multiple factors inherent to the disease itself have led to obesity becoming a common metabolic complication in CCAH patients. The mechanism of obesity in CCAH patients is complex and involves multiple factors related to both treatment and the disease itself. This article provides a narrative review of the incidence, influencing factors, related complications and treatment management strategies of obesity in CCAH patients, with the aim of offering comprehensive management recommendations for clinical practice.