Testosterone and weight loss

Abstract

Purpose of reviewThe purpose of this article is to examine the contemporary data linking testosterone therapy in overweight and obese men with testosterone deficiency to increased lean body mass, decreased fat mass, improvement in overall body composition and sustained weight loss. This is of paramount importance because testosterone therapy in obese men with testosterone deficiency represents a novel and a timely therapeutic strategy for managing obesity in men with testosterone deficiency.Recent findingsLong-term testosterone therapy in men with testosterone deficiency produces significant and sustained weight loss, marked reduction in waist circumference and BMI and improvement in body composition. Further, testosterone therapy ameliorates components of the metabolic syndrome. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity.SummaryThe implication of testosterone therapy in management of obesity in men with testosterone deficiency is of paramount clinical significance, as it produces sustained weight loss without recidivism. On the contrary, alternative therapeutic approaches other than bariatric surgery failed to produce significant and sustained outcome and exhibit a high rate of recidivism. These findings represent strong foundations for testosterone therapy in obese men with testosterone deficiency and should spur clinical research for better understanding of usefulness of testosterone therapy in treatment of underlying pathophysiological conditions of obesity.

Testosterone therapy in men with testosterone deficiency: Are we beyond the point of no return?

“…It is universally accepted that T therapy in men with TD increases muscle mass and reduces fat mass (Table 2) [49]. T therapy improves bone mineral density [5051], reduces adipogenesis [5253] and improves anthropometric parameters (Tables 1 and 2) [8].…”

RAS and sex differences in diabetic nephropathy

“…T2DM is associated with augmented E 2 levels in men (123,124). These increased E 2 levels are associated with complications, such as atherosclerosis, in men with T2DM and metabolic syndrome (35,65).…”

“…Testosterone replacement therapy (TRT) in men with T2DM improved some of the key parameters associated with metabolic syndrome in several observational, retrospective, and prospective trials (38,55,79,119). In particular, body weight, waist circumference, blood pressure, heart rate, fasting blood glucose and insulin sensitivity, as well as HbA 1c , triglycerides, cholesterol, and low-density lipoprotein levels were significantly improved in type 2 diabetic men receiving TRT for at least 24 mo (34,123,141). In concordance, TRT in nine men with T1DM, erectile dysfunction, and hypogonadism improved in glycemic control, lipid profiles, and erectile function (104).…”

Horizons in the Pharmacotherapy of Obesity

“…Moreover, weight loss has also been demonstrated in controlled studies of shorter duration. Markers of metabolic and cardiovascular health are improved in hypogonadic men [96,97] but not in men without hypogonadism [98]. However, some studies have suggested that testosterone might increase cardiovascular risk, and although these have been strongly criticised, the FDA has decided to review the risks associated with testosterone treatment [97,99].…”