Obesity is now recognized as one of the most important public health problems facing the world today. Overweight and obesity may increase the risk of many health problems, including diabetes, heart disease, and certain cancers.
Obesity on the other hand, is very common in men with testosterone deficiency. Although no cause effect between testosterone levels and obesity has been established, it seems that the progressive decline of testosterone levels while we are getting older may also contribute to the accumulation of body fat which occurs over the years. Consequently it is of great importance the findings of a study which has shown that long-term testosterone therapy can help men with low testosterone lose weight and maintain their weight loss. The findings of this study were presented at 2019 Endocrine Society’s annual meeting.
To this regard 462 overweight men in their late fifties to mid-sixties, with low testosterone levels were followed for a ten years period in an ongoing observational registry study. Patients were given the choice whether to be treated with long-term testosterone therapy. Of these, 273 opted to receive testosterone, and the 189 who declined treatment served as controls. Over 10 years, the testosterone-treated men lost 20.3 percent of their baseline weight (50.5 lb; 22.9 kg); their waist circumference dropped by 12.5 cm (4.9 in). BMI decreased by 7.3 kg/m2, and the waist-to-height ratio decreased by 0.07.
By contrast, the untreated men gained 3.9 percent of their baseline weight (3.2 kg; 7.1 lb), and their waist size increased by 4.6 cm (1.8 in). In this group, BMI increased by 0.9 kg/m2, and waist-to-height ratio increased by 0.03.
During this time, 12 (4.4 percent) men in the testosterone group died, while in the untreated control group, 57 deaths (30.2 percent), 47 myocardial infarctions (24.9 percent) and 44 strokes (23.3 percent) occurred.
This study demonstrates that long-term testosterone replacement treatment in men with testosterone and obesity results in significant improvement in measures of body size and composition. In addition, testosterone treatment was associated with a reduced risk of death, heart attack and stroke.
This suggests testosterone levels should be measured in men with obesity, and testosterone therapy should be offered if indicated