Weight gain and low testosterone levels are correlated on multiple levels. The primary way by which testosterone promotes a healthy weight is by contributing to lean muscle mass, preserving bone density, and ensuring baseline cortisol levels under periods of stress. Testosterone also affects insulin sensitivity and glucose metabolism in the body, because of which, low testosterone levels are often seen in type 2 diabetes patients.

Testosterone replacement therapy (TRT), if prescribed by a licensed practitioner, can help revive the body’s testosterone levels and help in battling weight loss. However, there is no one formula which works for everyone and patients need to consult a specialist before opting for TRT.

What is Testosterone?

Testosterone is a sex hormone produced in the testes in males and in smaller amounts in the adrenal cortices and ovaries in females; it is the primary male sex hormone. Testosterone is essential for the growth of male sexual characteristics, the male reproductive system, vocal changes, and the growth of body and facial hair. However, it is also the key to the development and maintenance of bone and skeletal muscle mass and the production of red blood cells. Testosterone also has a significant impact on mood and overall mental health. (1)

Also Read: How TRT can help with Depression

Low testosterone levels impact body fat accumulation (especially central adiposity), reduce lean mass and can significantly contribute to weight gain, apart from an obvious decline in libido. Testosterone is an androgen, and androgens are known to affect fatty acid metabolism, glucose control and energy utilization in specific tissues, with different effects seen in different fat depots.(2) There has been a bidirectional relationship between testosterone levels and obesity in people, wherein weight loss has also been complemented by a rise in testosterone levels.(2)

Also Read: How Low Testosterone is Linked to Belly Fat

Reduced muscle mass, less sex drive, fatigue, and weight gain are just a few of the symptoms that low testosterone levels can bring in men. This is because testosterone has an impact on the body's capacity to develop and maintain muscle mass, which can directly affect weight gain.

Also Read: Causes and Symptoms of Low Testosterone

Increased insulin resistance has also been connected to low testosterone levels (4,5). The hormone insulin aids in controlling the body's blood sugar levels.

What Causes Low Testosterone Levels In The Body?

Ageing is the most prominent, natural cause of low testosterone levels in the body. Once a man crosses his thirties, there is a steady 1% decline in testosterone levels with every passing year. As per the Baltimore Longitudinal Study of Aging, hypogonadism – a clinical condition where the gonads produce low testosterone (also referred to as Low T syndrome), is present in 20% of men over 60 years of age, 30% of men over 70 years, rising to 50% of men over 80 years of age.(3) This decline is due to the increase in the amount of sex-hormone-binding globulin proteins (SHBG) which further limits the availability of free (bioavailable) testosterone.

Hypogonadism can affect men in two ways: primary hypogonadism due to abnormality in the testes, and secondary hypogonadism due to damage or abnormality in the hypothalamus or the pituitary gland, because of which the testes do not secrete enough testosterone.

What Are The Symptoms Of Low Testosterone In The Body?

Both primary and secondary hypogonadism manifest themselves over time. During the fetal/developmental/pubertal stage, the most common symptoms of low testosterone levels include (4)

• Ambiguously formed genitals
• Underdeveloped genitals
• Reduced muscle mass
• Underdeveloped facial hair
• Feeble voice (due to hampered voice deepening)
• Gynecomastia (overdeveloped breast tissue in men)
• Excessive growth of arms and legs in comparison to the trunk

The most common symptoms of low T in adulthood and ageing men include,

• Reduced sex drive, ejaculation volume and sexual arousal
• Mood swings, irritability, reduced attention span, and depression
• Infertility (in severe cases)
• Reduced lean muscle mass and increase in central adiposity
• Risks of developing osteoarthritis and osteoporosis

What is The Role of Testosterone in Weight Gain?

The relationship between low testosterone levels and weight gain is multifactorial – it also encompasses body mass index, waist circumference, type 2 diabetes, and other metabolic conditions as well.

In normal, healthy men, testosterone aids in reducing body fat and increasing lean muscle mass. Testosterone encourages muscle tissue growth and development, which aids in boosting metabolism and burning calories. Hence, low T conditions reduce lean body mass and lead to central adiposity and weight gain.

Also Read: How Metabolism Testing Helps Reduce Weight

The hormone insulin aids in controlling the body's blood sugar levels. The body's cells become less responsive to insulin when there is insulin resistance, which can result in high blood sugar levels and a higher risk of developing type 2 diabetes. To prevent insulin resistance and control blood sugar levels, testosterone works to increase insulin sensitivity. Insulin sensitivity is decreased by low testosterone levels, which can result in weight gain and a higher risk of type 2 diabetes.

On the other hand, obese men may have abnormal levels of reproductive hormones (like testosterone), and adipose tissue is known to aromatize testosterone into estradiol. (2) Additionally, insulin resistance with compensatory hyperinsulinemia in addition to excess aromatization to estradiol can affect the hypothalamic-pituitary gonadal axis, also causing low testosterone levels in obese subjects. (5)

Additionally, a rise in the production of the stress hormone cortisol has been connected to low testosterone levels. Cortisol levels that are elevated have been linked to weight gain and the buildup of abdominal fat, which is a risk factor for several diseases like heart disease and type 2 diabetes.(6)

Cortisol excess can lead to weight gain and fat deposition, especially in the abdominal region. The bloodstream is stimulated to release glucose by cortisol, giving the body the energy it needs to deal with stress. Underutilized, excess blood glucose is stored as fat in the body. High levels of cortisol can also increase cravings for high-fat, high-sugar foods and increase appetite, which can lead to weight gain.

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Do Low Testosterone Levels Make You Gain Weight?

Low testosterone levels and obesity are strongly correlated. Multiple studies have shown that men with low testosterone levels have a higher likelihood of being overweight than men with normal testosterone levels.

Also Read: Weight Loss Medications: All You Need to Know

A 2017 study found that 5-point decrease in BMI could be linked to a 13% increase in testosterone levels. Another study discovered that males with low testosterone levels have higher fat mass and lower lean mass, both of which are linked to metabolic dysfunction. Another 2017 review showed that testosterone therapy has the potential to help obese men with low testosterone levels lose weight, improve their quality of life, and manage the complications associated with obesity.(7)

Not only in men, obesity is frequently seen in women with polycystic ovarian syndrome (PCOS), which is characterized by excess testosterone in women and can be characterized by increased free androgen index, hirsutism, fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance index.

Also Read: What is PCOS Belly?

How can Testosterone Replacement Therapy (TRT) Affect Weight Loss

Testosterone Replacement Therapy can aid in weight loss in several different ways, primarily doing so by boosting lean muscle mass. Lean muscle tissue burns more calories at rest than fat tissue because it has a higher metabolic activity. Multiple studies have shown the benefits of TRT in improving body fat mass, waist circumference, and muscle mass, as well as benefits against cardiometabolic risk factors in hypogonadal men. (2)

TRT can also aid in weight loss by enhancing insulin sensitivity. Meta-analyses of studies have shown that TRT is associated with marked reduction in waist circumference as well as measures of type 2 diabetes and a simultaneous increase in HDL (good cholesterol), suggesting that TRT can improve metabolic control and may reduce central obesity.(2)

TRT has also been demonstrated to suppress the production of excess cortisol, a stress hormone that has been linked to weight gain. TRT can be beneficial in reducing excess stress and weight gain by suppressing excess adrenocorticotropic hormone (ACTH)-induced cortisol secretion.(8)

Also Read: Could TRT be right for you?

Also Read: Can you stop TRT once you start?

And Finally…

Testosterone serves multiple important functions in the body and they go beyond the usual perception of maintaining sexual mobility and libido. Its crucial impacts on stress control, lean muscle mass and bone density maintenance can cause life-altering conditions if not taken proper care of. TRT is beneficial in overcoming low testosterone levels in hypogonadal males, who are prescribed the same by a licensed practitioner. However, it is also important to note and understand that not everyone will need TRT in their lifetime. Simple lifestyle modifications can also help in boosting endogenous testosterone levels in the body. If you are looking for TRT in Canada, get in touch with a medical professional at Science & Humans for a telephonic conversation, right from the comfort of your home.

FAQ

Are there any alternate approaches to testosterone replacement therapy? Does one need any complementary therapy?

Not everyone will need medical therapy for testosterone levels. Testosterone is secreted naturally by the testes and there are always lifestyle modifications to boost testosterone levels worth trying, before heading to a doctor. Ensuring the right nutritional intake, incorporating lean meat, fatty fish, nuts, leafy greens, and vitamin D is crucial for overall well-being as well. Adequate sleep can naturally reduce stress build-up. An active lifestyle with at least two hours of strength training in a week, is also beneficial in improving overall strength and mobility and keeping a check on metabolic conditions if any.

How long does it take for one to notice visible effects of TRT?

Any time between 2-3 months can be a good window period to notice changes due to TRT. However, the specialist prescribing the treatments will also mention the exact nature of follow-up treatments and monitor the serum testosterone levels closely, in order to modify or change a regimen.

I do not have hypogonadism, but low-to-normal testosterone levels. I do have obesity. What should I do?

Speak to a licensed practitioner. Only being obese and not having clinically low testosterone levels may not necessarily need TRT, but mostly lifestyle changes. However, if the diagnostics and the practitioner’s assessment suggest TRT, then it should be the go-to option.