- Battle of the Bulge: Low T and Weight Management
- Testosterone and Weight Loss
- Diet, “Dieting,” and Testosterone
- Summing it Up
- How Low Testosterone Impacts Weight Gain
- Testosterone and weight gain
- Testosterone replacement
- Belly fat in men: what you can do to reduce it
- Specific Hormonal Causes or Contributors to Male Weight Gain
- The Solution: Male Weight Loss
- Can Boosting Your Testosterone Help You Lose Fat?
- In some men, taking testosterone while dieting may help lose fat, not muscle
Battle of the Bulge: Low T and Weight Management
Men depend on the male hormone testosterone for everything from helping to build muscle to giving facial hair and a deeper voice. Research also shows that weight control can be added to that list.
“Testosterone has a critical role in metabolism,” says Abraham Morgentaler, MD, an associate clinical professor of urology at Harvard Medical School and director and founder of Men’s Health Boston. “Multiple studies have shown men with low testosterone have a higher percentage of body fat than men with higher testosterone.
Further evidence: Men who take medication to severely depress testosterone levels as treatment for advanced prostate cancer rapidly gain weight and increase body fat, according to Dr. Morgentaler.
The testosterone-weight connection also goes the other way. A 2013 review of weight loss and its effects on testosterone published in the European Journal of Endocrinology found that weight loss alone — without testosterone therapy — was associated with increases in testosterone levels.
Also, a 2013 German observational study published in the journal Obesity found that weight loss was an added bonus for men with low testosterone who were taking testosterone replacement therapy. The men took testosterone supplements for five years and lost an average of 36 pounds and 3.5 inches off their waists.
The Low Testosterone-Weight Gain Mystery
Low testosterone causes increases in body fat, especially in the midsection.
But why does this happen? “The exact biochemical mechanism by which testosterone causes this change is unknown,” Morgentaler explains.
However, it turns out that not only does low testosterone seem to cause weight gain in men, the reverse also seems to be true: Obesity is one of the risk factors for lower than normal levels of testosterone. Physiologically, the relationship between low testosterone and weight gain in men can become a vicious cycle.
“Body fat contains an enzyme that converts testosterone into estrogens,” says David Samadi, MD, chairman of the urology department at Lenox Hill Hospital in New York City. “Having extra estrogens triggers the body to slow its production of testosterone. The less testosterone you make, the more belly fat you accumulate, and so on.”
For men who already have low testosterone, excess body fat can worsen the condition: “Fat speeds up the metabolizing of testosterone,” Dr. Samadi says. “Therefore, the more fat you carry around, the faster you’ll burn through the already low testosterone levels in your body.”
However, not all men with low testosterone are overweight, and the symptoms vary from man to man. “Being overweight can worsen your ability to produce testosterone and can lower already low testosterone, but you don’t need to be overweight to be affected by low testosterone,” adds Samadi.
Regardless of weight, men with low testosterone are more likely to have less muscle than those with normal levels. “Even in men with low testosterone who are not overweight, it is likely they will have an increased percentage of body fat,” Morgentaler says.
A Recipe for Couch Potatoes
Another important reason low testosterone is tied with weight gain in men is the symptoms can take away incentive to exercise. “One of the subtle symptoms of low testosterone is that it often reduces motivation,” Morgentaler says. “Men describe this feeling as if they have become a couch potato. Staying fit and trim requires energy and drive, and if these are lacking, it is easier to gain weight.”
Even if you are able to drag yourself to the gym, low testosterone could mean you have less stamina to get through your workout and see results, which can be discouraging.
Tips for Managing Weight With Low Testosterone
To fight weight gain with low testosterone, the advice is the same as for others trying to drop pounds: Eat less and exercise more.
Weight lifting or another form of resistance exercise is particularly important. “This type of workout helps build more muscle faster and triggers testosterone production,” Samadi says. “Additionally, your body burns more fat for energy during resistance exercise, helping promote healthy weight and fat distribution.”
Treating low testosterone can boost overall energy, easing fatigue and prompting you to get moving and lose weight. Although testosterone supplements shouldn’t be used to help men with symptoms of low testosterone drop pounds, if you have measurably low testosterone, treating it should make weight loss easier. “Normal levels of testosterone encourage fat loss, increased muscle mass and strength, and stamina,” Morgentaler says. “Also, workouts are better, and men feel encouraged by this, so they do them more often.”
Testosterone isn’t just a question for the 40-and-up crowd. Far from it: if you’re a human being (male or female) who wants to lose fat (or keep it lost), gain muscle (or keep it gained), or yes, enjoy sex, then testosterone is important for you to know about.
It’s important to note, though, that testosterone does work differently in men and in women, so the advice for one sex doesn’t necessarily apply to the other. For example, diabetes and obesity are associated with lower testosterone in men, but higher testosterone in women.
Because a full explanation of all things testosterone would probably fill a book, here we’ll just be focusing on what men need to know about testosterone and weight loss. Why is testosterone important for men who want to lose weight, what are the effects of diet on testosterone, and how can Paleo help with hormone regulation during weight loss?
Testosterone and Weight Loss
In healthy men, testosterone is a wonderful boon for fat loss (as opposed to just “weight” loss). As you could probably guess, this is particularly important for older men, but it’s still an issue for the 20somethings in the room. Testosterone helps build muscle, which ramps up your insulin sensitivity, maintains metabolic health, and delivers all kinds of other important benefits.
You can see just how important this is by looking at the worst-case scenario: low testosterone and obesity create a vicious cycle. Obesity impairs the production of testosterone, and lower testosterone makes it easier to store more fat. Low testosterone may also contribute to insulin resistance (the metabolic inability to handle carbs), ensuring that any carbs you eat will be shuttled off directly to fat tissue. Lower testosterone levels are also associated with other aspects of metabolic syndrome. Weight loss does improve testosterone levels, but only if you can break out of that vicious cycle in the first place.
Overall, it’s pretty clear that healthy testosterone levels are important for achieving and maintaining a healthy weight – and more importantly, a healthy body fat percentage. You can be skinny but still metabolically unhealthy; the real goal isn’t just a smaller number on the scale, but a better balance of muscle and fat (this is also what makes you look better naked).
With that said, it’s a cruel twist of fate that “dieting” in the traditional sense of the word is one of the worst things you can do for your testosterone levels.
Diet, “Dieting,” and Testosterone
The bad news for men who want to lose weight is that most “diets” dramatically lower testosterone levels (one reason why they tend to kill libidos so effectively). It’s hard to avoid this entirely if you want to lose weight, but if you take a look at the reasons why “dieting” lowers testosterone it’s clear that there are at least a few ways to modify this.
Fat Restriction Reduces Testosterone
Most “diets” involve eating a bunch of low-fat food and passing up the butter. Unfortunately for dieters, study after study has proven that eating a bunch of low-fat, high-fiber “diet food” is a fantastic way to tank testosterone levels, especially if the fat you do eat is polyunsaturated (PUFA).
The solution: for the love of your own abs (or for the hope of seeing them!), just say no to low-fat dieting! Instead, eat plenty of the good fats.
- Saturated fat: it’s hard to tease out the effect of saturated fat specifically from the effects of total dietary fat. But some studies (like this one) have observed associations between percent energy from saturated fat and resting testosterone concentrations, so the evidence is at least suggestive that there might be an effect. It’s also worth noting that vegetarians (who consume less fat and much less saturated fat) have lower testosterone levels than omnivores.
- Monounsaturated fat: This study found that olive oil and argan oil (both high in monounsaturated fat) increased testosterone levels in healthy young men.
There’s a huge amount of back-and-forth about whether saturated or monounsaturated fat is “better” for raising testosterone, but if you’re eating a solid Paleo diet, you should be getting enough of both to get the maximum benefit so it doesn’t really matter.
Weight Loss Reduces Testosterone
Any kind of energy deficit (eating fewer calories than you take in) lowers testosterone levels, because the resulting weight loss steals some muscle mass along with the fat. This is inevitable; there’s no way to lose only fat with absolutely 0 muscle loss. That means that any weight loss will reduce testosterone to at least a small degree, but there’s no reason to make it any worse than it has to be!
The solution: preserve lean mass while losing weight. The more of your muscle mass you keep, the less testosterone you’ll lose. Here’s how to do it:
- Do resistance training (weightlifting) during weight loss to maintain strength and muscle mass. On the other hand, don’t go so crazy with exercise that you overstress your body (see below).
- Eat enough protein, but there’s no need to go overboard: just eating more protein doesn’t help.
Stress Reduces Testosterone
Who likes “dieting”? Nobody. “Dieting” in the sense of “starving yourself thin” is stressful and painful. Those feelings of stress and general craziness are the results of a hormone called cortisol, which is the “fight-or-flight” master of the hormonal system. If you need a sudden burst of strength and speed (you get attacked, your kid falls into a river, you’re trapped in a burning building), cortisol is great, but when it’s constantly elevated, cortisol becomes a problem. And unfortunately for the dieters of the world, producing more cortisol is a great way to lower testosterone levels.
The solution: keep cortisol levels low by generally reducing the stress in your life. This might sound a little crazy, but if a diet is driving you insane, find a different diet. Get 8-9 hours of sleep every night: sleep deprivation reduces testosterone levels, too. Don’t run yourself into the ground at the gym, and eat enough for the workouts that you do. It’s not complicated; it just takes a little common sense.
Summing it Up
As discussed in the intro, women work a little differently when it comes to testosterone – that’s a topic for another day. But for men, at least, it should be pretty clear that the conventional model of “dieting” isn’t doing anyone’s testosterone levels any favors. It’s much more pleasant (and easier!) to lose weight in a way that preserves testosterone as much as possible.
If you’re interested in making that happen, Paleo gives you a much better shot at it than just restricting calories and making better friends with your treadmill. Eat enough protein and enough healthy fat, lift some heavy weights once in a while, and don’t do things that make you crazy, stressed out, or miserable. It may also help to eat some oysters every now and again, or otherwise make sure you’re getting enough zinc.
You might not see the number on the scale go down quite as fast this way (because you’re preserving your muscle mass, which is all the same “weight” to the scale), but the weight loss will be easier to maintain and a lot less painful – and it’ll leave your sex drive, mood, and overall health intact.
How Low Testosterone Impacts Weight Gain
Dr. Ferro will rule out any underlying medical issues such as liver disease and type 2 diabetes that may be causing your symptoms. Low testosterone can affect your health in ways that go beyond weight gain. It increases your risk of heart disease, depression, and bone problems to name a few.
A normal testosterone range is 300-1,000 ng/dl, and something is usually off if you have a level of 200 or lower. Look out for these common low testosterone signs:
- Problems maintaining an erection
- Hair loss
- Weight gain
- Loss of muscle mass
- Changes in mood
- Low sex drive
Testosterone and weight gain
Testosterone helps you build and retain muscle and plays a role in fat storage and fat distribution, all of which impact your weight. The loss of muscle mass in men with low testosterone affects metabolism and the number of calories burned. When your muscle mass drops, so does your metabolism, making it easier to gain weight.
Additionally, because testosterone influences where you store fat, low levels of this hormone are linked to excess fat in the abdominal area, which raises your risk for heart disease. In a cruel twist, excess fat impairs your body’s ability to utilize testosterone effectively, setting off a vicious cycle.
The good news is, men who have low testosterone and struggle with weight tend to experience significant weight loss once on testosterone therapy as it corrects the amount of testosterone in your body. This helps you build and retain muscle and shed extra fat. Combined with moderate exercise and a healthy diet, you should see an improvement in your weight and other low testosterone symptoms.
To discuss testosterone replacement therapy and find out if it’s the right option for you, call our office to schedule an appointment with Dr. Ferro, or book online.
Belly fat in men: what you can do to reduce it
FORT LEONARD WOOD, Mo.-Men, for the most part, complain that they gain weight in their waistline. This can be frustrating and uncomfortable for most and can cause concerns with other health issues associated with carrying extra weight in their midsections.
Here are some reasons men tend to carry a few extra pounds in their belly.
Low Testosterone Levels
Belly fat and low testosterone are known to be linked with each other. As many men age their testosterone levels tend to decrease and they tend to gain more belly fat. Body fat has an enzyme called aromatase that converts testosterone into estrogens. When someone has higher estrogen levels in their body, their hormonal system tells the body to slow down its production of testosterone. Less testosterone tends to mean more belly fat. It’s common for men to lose testosterone as they age, however weight gain can accelerate the process. Staying active and eating healthy can help men avoid the annoying habit of developing the infamous “pot belly.”
Have you ever noticed how some relatives seem to all have similar body shapes and gain weight in similar areas? Genetics does play a role in fat storage. Fat cells are all over the bodies and some areas have more fat cells than others. The body will gain more fat in the “fat-favored” areas. Fat cells contain hormones, toxins, and triglycerides all of which contribute to the growth and storage of fat. Unfortunately some families are at higher risk to gain fat in unhealthy area.
Carrying extra fat in your waistline can be annoying and cause a number of health issues. Take the time to really assess your lifestyle and see where you could make changes to ensure you don’t end up with this issue. Ensuring that exercise and eating a healthy diet are a part of your everyday routine can be critical to your health.
Try to get in 30 min of cardio at least four days a week and incorporate two days a week of strength/resistance training. Building and maintaining muscle is beneficial to maintaining healthy testosterone levels.
Eat the right amount of calories. Men tend to need at least 1,800 calories a day. Not eating enough or eating too much can both cause belly fat. When you eat too little it can cause the body to store fat to use as energy later because it is not currently getting enough food for energy to use throughout the day. Ensuring you eat the right amount of calories based on your resting metabolic rate and lifestyle can effectively aid in developing and maintaining a healthy weight.
(Editor’s note: Kaylene Pursley, Health Educator at Fort Leonard Wood’s Army Wellness Center)
While the cause and effect relationship is not clear, it is apparent that there is a strong connection between weight gain in men and andropause related hormonal imbalances. Low testosterone and high cortisol seem to increase body fat, especially in the midsection, and decrease muscle mass in men. This body fat seems to further the hormonal imbalance by converting testosterone into estrogen. Male weight gain coupled with muscle loss means more weight to carry and less muscle to carry it with, resulting in fatigue and low energy levels.
Specific Hormonal Causes or Contributors to Male Weight Gain
Weight gain in men is affected by high stress or cortisol levels in the body. Prolonged heightened levels of cortisol put the body into survival mode and induce the production of fat cells and the decline of metabolism to store food for later use. The cortisol also increases appetite in order to procure energy for “fight or flight”. Male weight gain naturally follows.
High cortisol levels further diminish levels of testosterone, which already suffer during andropause. Low testosterone can cause low energy and fatigue, meaning less physical activity and weight gain in men. Thyroid disorders, particularly hypothyroidism, and low levels of the human growth hormone (HGH) often cause weight gain by way of decreasing the body’s metabolic rate.
The Solution: Male Weight Loss
The imbalances of several hormones come into play when talking about weight gain in men. It makes sense that balancing these hormones has a big impact on weight loss. With the help of bioidentical hormones, we can bring your testosterone, cortisol, estrogen, HGH and thyroid hormones, among others, into more optimal levels. This balance will provide the platform for weight loss to be much more attainable.
BodyLogicMD treats andropause weight gain in three parts: bioidentical hormone replacement therapy, nutrition plans, and a targeted supplement regimen as well as recommendations for routine physical activity. Following this treatment can make male weight loss a reality.
Contact the BodyLogicMD affiliated bioidentical hormone replacement therapy physician nearest you to schedule an appointment and learn more about how bioidentical hormone therapy is providing relief from weight gain in men.
Can Boosting Your Testosterone Help You Lose Fat?
The term “testosterone supplement” can refer to three things: illicit anabolic steroids, testosterone replacement therapy and testosterone boosters.
Illicit Anabolic Steroids
Synthetic steroids related to testosterone are collectively known as anabolic steroids. The term may also refer to testosterone itself.
Some bodybuilders misuse anabolic steroids to increase testosterone beyond normal levels and boost muscle growth. Yet abusing anabolic steroids is illegal in many countries, including the US (14).
Healthy men with normal testosterone levels should not take anabolic steroids in any form, since long-term misuse can cause adverse side effects. These include sexual dysfunction, aggressive behavior, liver problems and heart disease (15, 16, 17).
Some researchers have pointed out that not all of these side effects apply to testosterone itself but rather to its synthetic derivatives. In fact, testosterone plays a valid role in the treatment of some medical conditions (18).
For instance, it is legally prescribed to normalize testosterone levels in deficient men, a treatment known as testosterone replacement therapy (19).
While valid testosterone replacement therapy may promote weight loss in obese men, anabolic steroid misuse is not a recommended weight loss strategy.
Excessive muscle mass may be difficult to maintain in the long term and unused muscles tend to turn into fat over time.
Summary: Some bodybuilders misuse testosterone or related synthetic forms. Long-term misuse may lead to serious health problems.
Testosterone Replacement Therapy
This hormone is often legally prescribed to treat testosterone deficiency (hypogonadism) or other medical conditions.
The treatment is known as testosterone replacement therapy and is performed under medical supervision. It can be administered as a supplement, skin patch, cream or injection.
There is some evidence that replacement therapy can lead to weight loss in obese patients with testosterone deficiency (20, 21, 22, 23).
One 56-week study in 100 obese men on a reduced-calorie diet found that injections improved weight loss by 6.4 pounds (2.9 kg) compared to those who didn’t receive any treatment.
While both groups lost muscle mass as well as fat mass on a low-calorie diet, testosterone caused significant muscle regain during the weight maintenance period (24).
It leads to weight loss by promoting muscle growth, which in turn increases the number of calories burned.
It may also reduce fatigue, enhance motivation and promote greater physical activity. All of these factors play a major role in weight loss (8, 25).
Keep in mind that these studies examined the effects of replacement therapy in deficient men under medical supervision.
There is no evidence that replacement therapy causes weight loss in healthy men with normal testosterone levels.
Summary: Testosterone replacement therapy promotes weight loss in obese, testosterone-deficient men.
Also known as “natural testosterone supplements,” testosterone boosters increase the natural production of this hormone within your body.
These supplements do not contain any testosterone and are usually plant-based.
Some boosters, such as ashwagandha, D-aspartic acid and fenugreek seed extract, may raise testosterone levels and improve muscle growth in men who have low levels, although the evidence is inconsistent (26, 27, 28).
However, many of the health claims associated with boosters are not supported by science. For instance, Tribulus terrestris, a supplement commonly sold as a booster, does not appear to raise levels (29).
Currently, no studies have shown significant weight loss with testosterone boosters, although some tend to reduce fat mass.
Summary: Testosterone boosters enhance the natural production of testosterone within the body. Studies suggest that certain boosters may benefit men who are deficient.
Testosterone could be the magic weight-loss drug that men are looking for. Then again, it might not. A new study shows that obese men receiving testosterone shots lost weight, but doctors are divided on the value of the results.
Over the course of five years, obese men on hormone replacement therapy lost an average of 35 pounds each. Their body mass index also dropped from 34 to 29, moving them from the obese to overweight category. This coincided with improved cholesterol and triglyceride levels, as well as lower blood pressure.
The results are impressive, but some doctors doubt that it’s time to start ordering testosterone shots for obese men. The preliminary study, presented at the European Congress on Obesity, has yet to appear in a peer-reviewed journal, and was also sponsored by Bayer, which makes testosterone supplements.
Testosterone levels start to drop in most men between the ages of 40 and 50, with some men—like the ones in this study—complaining of symptoms like erectile deficiency, fatigue and lack of energy. Testosterone replacement therapy is sometimes prescribed for these conditions. Low testosterone has also been linked to obesity.
In this study, men were prescribed testosterone shots because of their low hormone levels. Researchers also noticed that they lost weight during the study, although it’s unclear whether this is a direct result of the hormone therapy. Normalizing the men’s testosterone levels could have increased their energy levels, which may have led to increased physical activity and weight loss.
The good news is that, in this study, testosterone therapy wasn’t linked to an increased risk of prostate cancer.
It is too soon, however, to say that the hormone is a “miracle weight-loss drug.” Larger, more rigorous studies are needed.
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In some men, taking testosterone while dieting may help lose fat, not muscle
Overall, 40 percent of obese men have a low testosterone. Weight loss due to calorie restriction is associated with increased circulating testosterone, and testosterone treatment reduces fat. However, researchers don’t know whether adding testosterone treatment to calorie restriction reduces fat mass more than calorie restriction alone.
“There is an epidemic of obesity and related functional hypogonadism, yet testosterone treatment remains controversial,” said principal investigator Mathis Grossmann, MD, PhD, FRACP, associate professor in the Department of Medicine at the University of Melbourne in Victoria, Australia. “This study shows for the first time that, among obese men with lowered testosterone, testosterone treatment augmented the diet-induced loss of total and visceral fat mass and prevented the diet-induced loss of lean mass.”
Dr. Grossman and colleagues conducted a clinical trial of 100 fairly healthy obese men from the local community between 20 and 70 years of age who had low testosterone levels. Overall, 20 percent of them had diabetes and 10 percent had heart disease.
For the first 10 weeks, all participants were placed on a strict 600 kcal per day very-low calorie diet. They were also encouraged to abstain from alcohol and perform at least 30 minutes a day of moderate exercise. From the 11th through the 56th week, participants in both groups used a weight-maintenance diet based on the Australian Commonwealth Scientific and Industrial Research Organisation (CSIRO) Total Wellbeing Diet comprising of normal foods.
Every 10 weeks over the 56-week-long study, 49 men also received injections of 1,000mg of intramuscular testosterone undecanoate, and 51 took placebo.
At the end of 56 weeks, both groups lost roughly 11 kg (24.2 lb). But those in the testosterone group lost almost exclusively fat, while those on placebo lost both lean and fat. The men taking testosterone lost 3 kg (6.6 lb) more body fat than those on placebo and maintained their muscle mass, while those on placebo lost 3.5 kg (7.7 lb) of muscle mass.
Australia’s National Health and Medical Research Council supported the study. Bayer Pharma AG provided testosterone, placebo and financial support but was not directly involved in the study.
- 1Dobbs R, Sawers C, Thompson F, Manyika J, Woetzel J, Child P et al Overcoming obesity: an initial economic analysis executive summary. McKinsey Global Institute November 2014.
- 2Bray GA. Why do we need drugs to treat the patient with obesity? Obesity (Silver Spring) 2013; 21: 893–899.
- 3Ryan DH, Bray GA. Pharmacologic treatment options for obesity: what is old is new again. Curr Hypertens Rep 2013; 15: 182–189.
- 4Charakida M, Khan T, Johnson W, Finer N, Woodside J, Whincup PH et al. Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60-64 years in the 1946 British birth cohort study: an epidemiological study. Lancet Diab Endocrinol 2014; 2: 648–654.
- 5Johansson K, Neovius M, Hemmingsson E. Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014; 99: 14–23.
- 6Adabag S, Huxley RR, Lopez FL, Chen LY, Sotoodehnia N, Siscovick D et al. Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study. Heart 2015; 101: 215–221.
- 7Finkelstein EA, Trogdon JG, Brown DS, Allaire BT, Dellea PS, Kamal-Bahl SJ. The lifetime medical cost burden of overweight and obesity: implications for obesity prevention. Obesity (Silver Spring) 2008; 16: 1843–1848.
- 8Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H et al. Swedish obese subjects study. Effect of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741–772.
- 9Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H et al. Bariatric surgery and long-term cardiovascular events. JAMA 2012; 307: 56–65.
- 10Carlsson LM, Peltonen M, Ahlin S, Anveden Å, Bouchard C, Carlsson B et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med 2012; 367: 695–704.
- 11Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009; 374: 1677–1686.
- 12Sjöström L, Peltonen M, Jacobson P, Ahlin S, Andersson-Assarsson J, Anveden Å et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014; 311: 2297–2304.
- 13Arterburn DE, Olsen MK, Smith VA, Livingston EH, Van Scoyoc L, Yancy WS Jr et al. Association between bariatric surgery and long-term survival. JAMA 2015; 313: 62–70.
- 14Look AHEAD Research GroupLook AHEAD Research GroupWing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med 2010; 170: 1566–1575.
- 15Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg 2014; 149: 275–287.
- 16Wadden TA, Victoria LW, Moran CH, Bailer BA. Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy. Circulation 2012; 125: 157–1170.
- 17Moyer VA. Screening for and management of obesity in adults: U.S. Preventive Services Task Force Recommendation. Ann Intern Med 2012; 157: 373–378.
- 18Dyson PA. The therapeutics of lifestyle management on obesity. Diabetes Obes Metab 2010; 12: 941–946.
- 19Brethauer SA, Aminian A, Romero-Talamás H, Batayyah E, Mackey J, Kennedy L et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg 2013; 258: 628–637.
- 20Pellitero S, Olaizola I, Alastrue A, Martínez E, Granada ML, Balibrea JM et al. Hypogonadotropic hypogonadism in morbidly obese males is reversed after bariatric surgery. Obes Surg 2012; 22: 1835–1842.
- 21Aversa A, Bruzziches R, Francomano D, Rosano G, Isidori AM, Lenzi A et al. Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 24-month, randomized, double-blind, placebo-controlled study. J Sex Med 2010; 7: 3495–3503.
- 22Aversa A, Bruzziches R, Francomano D, Greco EA, Fornari R, Di Luigi L et al. Effects of long-acting testosterone undecanoate on bone mineral density in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 36 months controlled study. Aging Male 2012; 15: 96–102.
- 23Behre HM, Tammela TL, Arver S, Tolrá JR, Bonifacio V, Lamche M et al. A randomized, double-blind, placebo-controlled trial of testosterone gel on body composition and health-related quality-of-life in men with hypogonadal to low-normal levels of serum testosterone and symptoms of androgen deficiency over 6 months with 12 months open-label follow-up. Aging Male 2012; 15: 198–207.
- 24Finkelstein JS, Lee H, Burnett-Bowie S-A, Pallais JC, Yu EW, Borges LF et al. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med 2013; 369: 1011–1022.
- 25Francomano D, Lenzi A, Aversa A. Effects of five-year treatment with testosterone undecanoate on metabolic and hormonal parameters in ageing men with metabolic syndrome. Int J Endocrinol 2014; 2014: 527470.
- 26Francomano D, Bruzziches R, Barbaro G, Lenzi A, Aversa A. Effects of testosterone undecanoate replacement and withdrawal on cardio-metabolic, hormonal and body composition outcomes in severely obese hypogonadal men: a pilot study. J Endocrinol Invest 2014; 37: 401–411.
- 27Borst SE, Yarrow JF, Conover CF, Nseyo U, Meuleman JR, Lipinska JA et al. Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men: a randomized, controlled trial. Am J Physiol Endocrinol Metab 2014; 306: E433–E442.
- 28Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes. Diabetes Care 2007; 30: 911–917.
- 29Kapoor D, Goodwin E, Channer KS, Jones TH. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol 2006; 154: 899–906.
- 30Svartberg J, Agledahl I, Figenschau Y, Sildnes T, Waterloo K, Jorde R. Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip. Int J Impot Res 2008; 20: 378–387.
- 31Pexman-Fieth C, Behre HM, Morales A, Kan-Dobrosky N, Miller MG. A 6-month observational study of energy, sexual desire, and body proportions in hypogonadal men treated with a testosterone 1% gel. Aging Male 2014; 17: 1–11.
- 32Heufelder AE, Saad F, Bunck MC, Gooren L. Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men with newly diagnosed type 2 diabetes and subnormal plasma testosterone. J Androl 2009; 30: 726–733.
- 33Kalinchenko SY, Tishova YA, Mskhalaya GJ, Gooren LJG, Giltay EJ, Saad F. Effects of testosterone supplementation on markers of the metabolic syndrome and inflammation in hypogonadal men with the metabolic syndrome: the double-blinded placebo-controlled Moscow study. Clin Endocrinol (Oxf) 2010; 73: 602–612.
- 34Zitzmann M, Mattern A, Hanisch J, Gooren L, Jones H, Maggi M. IPASS: a study on the tolerability and effectiveness of injectable testosterone undecanoate for the treatment of male hypogonadism in a worldwide sample of 1,438 men. J Sex Med 2013; 10: 579–588.
- 35Saad F, Haider A, Doros G, Traish A. Long-term treatment of hypogonadal men with testosterone produces substantial and sustained weight loss. Obesity (Silver Spring) 2013; 21: 1975–1981.
- 36Haider A, Yassin A, Doros G, Saad F. Effects of long-term testosterone therapy on patients with “diabesity”: results of observational studies of pooled analyses in obese hypogonadal men with type 2 diabetes. Int J Endocrinol 2014; 2014: 683515.
- 37Haider A, Saad F, Doros G, Gooren L. Hypogonadal obese men with and without diabetes mellitus type 2 lose weight and show improvement in cardiovascular risk factors when treated with testosterone: An observational study. Obes Res Clin Pract 2014; 8: e339–e349.
- 38Yassin A, Doros G. Testosterone therapy in hypogonadal men results in sustained and clinically meaningful weight loss. Clin Obes 2013; 3: 73–83.
- 39Hackett G, Cole N, Bhartia M, Kennedy D, Raju J, Wilkinson P et al. Testosterone replacement therapy improves metabolic parameters in hypogonadal men with type 2 diabetes but not in men with coexisting depression: The BLAST Study. J Sex Med 2014; 11: 840–856.
- 40Hackett G, Cole N, Bhartia M, Kennedy D, Raju J, Wilkinson P et al. The response to testosterone undecanoate in men with type 2 diabetes is dependent on achieving threshold serum levels (the BLAST study). Int J Clin Pract 2014; 68: 203–215.
- 41Bhattacharya RK, Khera M, Blick G, Kushner H, Nguyen D, Miner MM. Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS). BMC Endocr Disord 2011; 11: 18.
- 42Bhattacharya RK, Khera M, Blick G, Kushner H, Miner MM. Testosterone replacement therapy among elderly males: the Testim Registry in the US (TRiUS). Clin Interv Aging 2012; 7: 321–330.
- 43Garcia JA, Sanchez PE, Fraile C, Escovar P. Testosterone undecanoate improves erectile dysfunction in hypogonadal men with the metabolic syndrome refractory to treatment with phosphodiesterase type 5 inhibitors alone. Andrologia 2011; 43: 293–296.
- 44Allan CA, McLachlan RI. Androgens and obesity. Curr Opin Endocrinol Diabetes Obes 2010; 17: 224–232.
- 45Saad F, Aversa A, Isidori AM, Gooren LJ. Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review. Curr Diabetes Rev 2012; 8: 131–143.
- 46Saad F, Yassin A, Haider A, Doros G, Gooren L. Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men. Korean J Urol 2015; 56: 310–317.
- 47Bouloux PMG, Legros JJ, Elbers JMH, Geurts TBP, Kaspers MJGH, Meehan AG et al. for the Study 43203 Investigators. Effects of oral testosterone undecanoate therapy on bone mineral density and body composition in 322 aging men with symptomatic testosterone deficiency: a 1-year, randomized, placebo-controlled, dose-ranging study. Aging Male 2013; 16: 38–47.
- 48Yu G, Traish A. Induced testosterone deficiency: from clinical presentation of fatigue, erectile dysfunction and muscle atrophy to insulin resistance and diabetes. Horm Mol Biol Clin Invest 2011; 8: 425–430.
- 49Traish AM. Testosterone and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes 2014; 21: 313–322.
- 50Astrup A, Carraro R, Finer N, Harper A, Kunesova M, Lean ME et al. NN8022-1807 Investigators. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond) 2012; 36: 843–854.
- 51Gadde KM. Current pharmacotherapy for obesity: extrapolation of clinical trials data to practice. Expert Opin Pharmacother 2014; 15: 809–822.
- 52Calderón B, Galdón A, Calañas A, Peromingo R, Galindo J, García-Moreno F et al. Effects of bariatric surgery on male obesity-associated secondary hypogonadism: comparison of laparoscopic gastric bypass with restrictive procedures. Obes Surg 2014; 24: 1686–1692.
- 53Zoicas F, Droste M, Mayr B, Buchfelder M, Schöfl C. GLP-1 analogues as a new treatment option for hypothalamic obesity in adults: report of nine cases. Eur J Endocrinol 2013; 168: 699–706.
- 54Nauck M, Frid A, Hermansen K, Thomsen AB, During M, Shah N et al. Long-term efficacy and safety comparison of liraglutide, glimepiride and placebo, all in combination with metformin in type 2 diabetes: 2-year results from the LEAD-2 study. Diabetes Obes Metab 2013; 15: 204–212.
- 55Li CJ, Yu Q, Yu P, Yu TL, Zhang QM, Lu S, Yu DM. Changes in liraglutide-induced body composition are related to modifications in plasma cardiac natriuretic peptides levels in obese type 2 diabetic patients. Cardiovasc Diabetol 2014; 13: 36.
- 56Haider A, Zitzmann M, Doros G, Isbarn H, Hammerer P, Yassin A. Incidence of prostate cancer in hypogonadal men receiving testosterone therapy: observations from 5-year median followup of 3 registries. J Urol 2015; 193: 80–86.
- 57Morgentaler A. Goodbye androgen hypothesis, hello saturation model. Eur Urol 2012; 62: 765–767.
- 58Khera M, Crawford D, Morales A, Salonia A, Morgentaler A. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur Urol 2014; 65: 115–123.
- 59Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol 2009; 55: 310–320.
- 60Morgentaler A, Miner MM, Caliber M, Guay AT, Khera M, Traish AM. Testosterone therapy and cardiovascular risk: advances and controversies. Mayo Clin Proc 2015; 90: 224–251.