Male Obesity Associated Gonadal Dysfunction and the Role of Bariatric Surgery
Open accessAbstract
Obesity is an ever growing pandemic and a prevalent problem among men of reproductive age that can both cause and exacerbate male-factor infertility by means of endocrine abnormalities, associated comorbidities, and direct effects on the precision and throughput of spermatogenesis. Robust epidemiologic, clinical, genetic, epigenetic, and preclinical data support these findings. Clinical studies on the impact of medically induced weight loss on serum testosterone concentrations and spermatogenesis is promising but may show differential and unsustainable results. In contrast, literature has demonstrated that weight loss after bariatric surgery is correlated with an increase in serum testosterone concentrations that is superior than that obtained with only lifestyle modifications, supporting a further metabolic benefit from surgery that may be specific to the male reproductive system. The data on sperm and semen parameters is controversial to date. Emerging evidence in the burgeoning field of genetics and epigenetics has demonstrated that paternal obesity can affect offspring metabolic and reproductive phenotypes by means of epigenetic reprogramming of spermatogonial stem cells. Understanding the impact of this reprogramming is critical to a comprehensive view of the impact of obesity on subsequent generations. Furthermore, conveying the potential impact of these lifestyle changes on future progeny can serve as a powerful tool for obese men to modify their behavior. Healthcare professionals treating male infertility and obesity need to adapt their practice to assimilate these new findings to better counsel men about the importance of paternal preconception health and the impact of novel non-medical therapeutic interventions. Herein, we summarize the pathophysiology of obesity on the male reproductive system and emerging evidence regarding the potential role of bariatric surgery as treatment of male obesity-associated gonadal dysfunction.
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In men, obesity is a cause of hypogonadotropic hypogonadism resulting in spermatogenesis disturbances and erectile dysfunction.
“In men, obesity is a cause of hypogonadotropic hypogonadism resulting in spermatogenesis disturbances and erectile dysfunction.121–123”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [122]
The Testosterone Deficiency section says obesity is a strong risk factor for male secondary hypogonadism and that its effects include erectile dysfunction and changes in sperm and semen parameters. The Erectile Dysfunction section also describes obesity-related central hypogonadism. But the Sperm and Semen Parameters section says obesity’s effect on those parameters remains ambiguous, so the claim’s unqualified assertion of resulting spermatogenesis disturbances is stronger than the paper supports. (LLM, conf=0.83)
Experimental — accuracy not yet measuredObesity can be a cause of impaired fertility.
“Obesity can be a cause of impaired fertility.98,121,122”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [122]
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- Authors
- Sultan, S., Patel, A. G., El-Hassani, S., Whitelaw, B., Leca, B. M., Vincent, R. P., le Roux, C. W., Rubino, F., Aywlin, S. J. B., & Dimitriadis, G. K.
- Affiliations
- King's College Hospital NHS Foundation Trust (GB)
- Princess Royal University Hospital (GB)
- Corresponding author
- Dimitriadis, Georgios K.
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2020-06-19
- Volume
- 11
- Pages
- 408-408
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC7318874
- OpenAlex
- W3031982810
- Cited by
- 39
- References
- 81
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 6 · 2019: 1
- FWCI
- 0.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- male obesity, male infertility, bariatric surgery, gonadal dysfunction, testosterone, spermatogenesis, weight loss, epigenetic reprogramming, spermatogonial stem cells, paternal obesity, preconception health, lifestyle modification
- MeSH terms
- Gonadal Disorders, Humans, Male, Obesity, Bariatric Surgery
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