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In contrast, a study investigating the impact of surgery and high-dose CAB (≥ 2 mg/week) in patients with prolactinomas resistant to conventional CAB doses documented a neutral effect of pituitary surgery on body weight and BMI (62), raising the hypothesis that a relevant effect on body weight and BMI is strongly dependent on PRL normalization and that in patients with long-term uncontrolled hyperprolactinemia by DAs the beneficial impact of surgery on body composition may be limited

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