Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review

Saad, Farid; Aversa, Antonio; M. Isidori, Andrea; J. Gooren, Louis

doi:10.2174/157339912799424573

Cited by 148Hormonal and reproductive studiesAdipokines, Inflammation, and Metabolic DiseasesRegulation of Appetite and Obesity

Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review

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Saad, Farid, Aversa, Antonio, M. Isidori, Andrea, J. Gooren, Louis·2012·Current Diabetes Reviews

DOI 10.2174/157339912799424573PMC PMC3296126

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Abstract

OBJECTIVE: Obesity negatively affects human health. Limiting food intake, while producing some weight loss, results in reduction of lean body mass. Combined with moderate exercise it produces significant weight loss, maintains lean body mass and improves insulin sensitivity, but appears difficult to adhere to. Bariatric surgery is clinically effective for severely obese individuals compared with non-surgical interventions, but has limitations. Clinical and pre-clinical studies have implicated a role for testosterone (T) in the patho-physiology of obesity. EVIDENCE ACQUISITION AND SYNTHESIS: A literature search in PubMed on the role of T in counteracting obesity and its complications. RESULTS: Obesity per se impairs testicular T biosynthesis. Furthermore, lower-than-normal T levels increase accumulation of fat depots, particularly abdominal (visceral) fat. This fat distribution is associated with development of metabolic syndrome (MetS) and its sequels, namely type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). T treatment reverses fat accumulation with significant improvement in lean body mass, insulin sensitivity and biochemical profiles of cardiovascular risk. The contribution of T to combating obesity in hypogonadal men remains largely unknown to medical professionals managing patients with obesity and metabolic syndrome. Many physicians associate T treatment in men with risks for prostate malignancy and CVD. These beliefs are not supported by recent insights. CONCLUSION: While overall treatment of obesity is unsuccessful, T treatment of hypogonadal men may be effective, also because it improves mood, energy, reduces fatigue and may motivate men to adhere to diet and exercise regimens designed to combat obesity.

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Increased BMI is associated with low measured or calculated free and bioavailable testosterone.
“However, it is important to note that an increased BMI was associated with a low measured, or calculated, free and bioavailable testosterone (24).”
From Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis (2013) · cites this paper as [24]
The 'Relationship Between Testosterone and Obesity' section reports an inverse relationship between BMI and testosterone levels in men. It does not specify that this BMI association holds for measured or calculated free and bioavailable testosterone; its separate discussion of free and bioavailable testosterone concerns diabetes risk, not BMI. Page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
The overall effect of testosterone treatment on body weight and BMI in men with different testosterone status is inconsistent.
“but the overall effect on body weight and BMI in men with different T-status is inconsistent.”
From Causal relationship between obesity and serum testosterone status in men: A bi-directional mendelian randomization analysis (2017) · cites this paper as [7]
Most randomized, placebo-controlled trials have indicated that testosterone treatment increases lean mass and reduces fat mass in men with low serum testosterone.
“Most randomized, placebo-controlled trials have indicated that T treatment increases lean mass and reduces fat mass in men with low serum T [2–7]”
From Causal relationship between obesity and serum testosterone status in men: A bi-directional mendelian randomization analysis (2017) · cites this paper as [7]

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Authors: Saad, F., Aversa, A., M. Isidori, A., & J. Gooren, L.
Affiliations: Bayer (Germany) (DE)
Corresponding author: Saad, Farid
ORCID: Saad, Farid
Venue: Current Diabetes Reviews
Publisher: Bentham Science Publishers Ltd.
Published: 2012-03-01
Volume: 8
Issue: 2
Pages: 131-143
ISSN: 1573-3998 (ISSN-L)
DOI: 10.2174/157339912799424573
PMC: PMC3296126
OpenAlex: W2138332837
Cited by: 148
References: 109
Citations by year: 2026: 6 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 3 · 2019: 4 · 2018: 14 · 2017: 11 · 2016: 6 · 2015: 28 · 2014: 16 · 2013: 26 · 2012: 6
FWCI: 19.51
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: cc-by
Locations: Current Diabetes Reviews (publishedVersion)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords: testosterone replacement therapy, obesity, hypogonadism, metabolic syndrome, visceral fat, lean body mass, insulin sensitivity, type 2 diabetes, cardiovascular risk, prostate cancer risk, bariatric surgery, weight loss, medication adherence
MeSH terms: Diabetes Mellitus, Type 2, Diet, Reducing, Humans, Hypogonadism, Male, Obesity, Patient Compliance, Testosterone, Exercise, Metabolic Syndrome, Risk Reduction Behavior, Intra-Abdominal Fat

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Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review

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