My son (5 yr old with SW CAH) also eats pretty healthy and is very active. He is 46 inches tall and weighs 75 pounds. We recently switched to circadian rythmn dosing and have noticed a dramatic slowing of his weight gain (from 10 pounds in 3 months on traditional dosing to 6 pounds in 6 months on the circadian dosing).

His endo always evaluates the weight gain based on where my son is gaing weight. If it is all over his body (proportional) he attributes it to diet, exercise, and the appetite affect of steroids. (Since I know my son’s diet and exercise habits, I attribute it to cortisol’s affect on metabolism but that is a whole other story!)

If the weight is gained mainly in his torso, the endo attributes it to excess steroids. I also remember reading that a side effect of excess hydrocortisone is weight gain in the mid-section only. Sorry I can’t remember where I read it now. Did you say your daughter’s levels were good or is she showing oversuppression?