At the beginning of the course of the disease, patients may show uniform obesity of the trunk and extremities, which is not easily detectable as most of the obesity is mild or moderate. However, as the disease progresses, the patient gradually develops a full face, a thick neck and back and a bulging abdomen, which are typical symptoms of centripetal obesity. In the later stages of the disease, the limbs become thin due to excessive muscle wastage, in contrast to the hypertrophied torso.