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Central obesity is a well-known symptom of Cushing's syndrome, which is a condition caused by prolonged exposure to high levels of cortisol. In patients with Cushing's syndrome, the distribution of body fat becomes abnormal, leading to characteristic features such as fat accumulation around the abdomen and face (often referred to as a "moon face"). This shift in body composition is closely associated with the effects of excess cortisol on metabolism and fat distribution.

The other options do not align with the typical presentation of Cushing's syndrome. Weight loss is generally not a symptom; in fact, affected individuals often experience weight gain. Increased muscle mass is also not characteristic of Cushing's syndrome; rather, patients may experience muscle weakness and loss due to muscle catabolism driven by high cortisol levels. Hypotension is frequently not associated with Cushing's syndrome, as patients typically exhibit hypertension as a result of fluid retention and increased vascular reactivity from elevated cortisol levels.