Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: observational data from two registry studies
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BACKGROUND/OBJECTIVES: Long-term testosterone replacement therapy (TRT) up to 5 years has been shown to produce progressive and sustainable weight loss (WL) in hypogonadal men. This study investigated effects of long-term TRT up to 8 years in hypogonadal men with different obesity classes. SUBJECTS/METHODS: From two independent observational registries we identified a total of 411 obese, hypogonadal men receiving TRT in urological clinics. The effects of TRT on anthropometric as well as metabolic parameters were studied for a maximum duration of 8 years, mean follow-up: 6 years. All men received long-acting injections of testosterone undecanoate in 3-monthly intervals. RESULTS: In all three classes of obesity, T therapy produced significant WL, decrease in waist circumference (WC) and body mass index (BMI). In patients with class I obesity, mean weight decreased from 102.6±6.4 to 84.1±4.9 kg, change from baseline: -17.4±0.5 kg and -16.8±0.4%. WC in this group of patients decreased from 106.8±7.4 to 95.1±5.3 cm, change from baseline: -10.6±0.3 cm. BMI decreased from 32.69±1.4 to 27.07±1.57, change from baseline: -5.52±0.15 kg m(-2). In patients with class II obesity, weight decreased from 116.8±6.9 to 91.3±6.3 kg, change from baseline: -25.3±0.5 kg and -21.5±0.4%. WC decreased from 113.5±7.5 to 100.0±5.4 cm, change from baseline: -13.9±0.4 cm. BMI decreased from 37.32±1.45 to 29.49±1.71, change from baseline: -8.15±0.17 kg m(-2). In patients with class III obesity, weight decreased from 129.0±5.6 to 98.9±4.8 kg, change from baseline: -30.5±0.7 kg and -23.6±0.5%. WC decreased from 118.5±5.6 to 103.8±4.9 cm, change from baseline: -14.3±0.4 cm. BMI decreased from 41.93±1.48 to 32.46±1.59, change from baseline -9.96±0.29 kg m(-2). CONCLUSIONS: Testosterone therapy appears to be an effective approach to achieve sustained WL in obese hypogonadal men irrespective of severity of obesity. Based on these findings we suggest that T therapy offers safe and effective treatment strategy of obesity in hypogonadal men.
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Testosterone administered to men with hypogonadism and obesity induces skeletal muscle hypertrophy and reduces body weight and fat mass.
“Moreover, testosterone administered to men with hypogonadism and obesity not only induces skeletal muscle hypertrophy but also reduces body weight and fat mass [24].”
From Effects of Skeletal Muscle Hypertrophy on Fat Mass and Glucose Homeostasis in Humans and Animals: A Narrative Review with Systematic Literature Search (2025) · cites this paper as [24]
The Results report weight loss in testosterone-treated hypogonadal men across all three obesity classes. The Discussion describes reduced fat mass and increased lean body mass, but this observational study did not directly measure fat mass or establish skeletal muscle hypertrophy. The claim presents those body-composition effects more definitively than this source supports. (LLM, conf=0.86)
Experimental — accuracy not yet measuredObservational studies with longer follow up suggest that testosterone treatment-associated fat loss is progressive over time with greater amount of fat loss observed in studies with longer duration.
“Observational studies in contrast, 82 , 94 with longer follow up, suggest that testosterone treatment‐associated fat lass is progressive over time with greater amount of fat loss observed in studies with longer duration (Table 1).”
From The role of the androgen receptor in the pathogenesis of obesity and its utility as a target for obesity treatments (2022) · cites this paper as [94]
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“Moreover, testosterone administered to men with hypogonadism and obesity not only induces skeletal muscle hypertrophy but also reduces body weight and fat mass [24].”
- Authors
- Saad, F., Yassin, A., Doros, G., & Haider, A.
- Affiliations
- Gulf Medical University (AE)
- Boston University (US)
- Corresponding author
- Saad, F
- Venue
- International Journal of Obesity
- Published
- 2015-07-29
- Volume
- 40
- Issue
- 1
- Pages
- 162-170
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- PMC
- PMC4722240
- OpenAlex
- W2203168867
- Cited by
- 131
- References
- 60
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 4 · 2023: 4 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 13 · 2018: 20 · 2017: 19 · 2016: 20 · 2015: 5
- FWCI
- 18.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Obesity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- testosterone replacement therapy, hypogonadism, obesity, weight loss, waist circumference, body mass index, testosterone undecanoate, obesity class, anthropometric parameters, metabolic parameters, long-term treatment outcomes, registry study, urological clinic
- MeSH terms
- Androgens, Follow-Up Studies, Germany, Humans, Hypogonadism, Male, Middle Aged, Obesity, Prospective Studies, Registries, Risk Factors, Testosterone, Time Factors, Weight Loss, Treatment Outcome, Men's Health, Waist Circumference
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