Obesity – A major predictor of low testosterone in men

Men with a body mass index of 30 or greater are considered obese and are more likely to suffer from low testosterone levels. This connection between a man’s levels of testosterone and obesity has been found in various studies including a 2014 study finding that obese men were more than 8 times more likely to have low testosterone than men of a healthier body weight.

The problems of low testosterone

The most important hormone found in a man’s body is testosterone. From functioning as a regulator of a healthy sex drive to maintaining the male physique to increasing a man’s competitive nature, testosterone has far-reaching and powerful effects on a man’s body and mind.

That’s why when a man’s testosterone levels plummet, his health will be at risk. While it’s not unusual for testosterone to decline – after the age of 40, it can reduce by 1 to 2 percent a year – it’s the side effects of low testosterone grabbing a man’s attention. Low libido and energy levels, erectile dysfunction, depression, loss of muscle and bone mass, breast growth, increased fat mass, and changes in sleep patterns, all can lead to serious long-term health issues such as diabetes, hypertension, and heart disease.

A normal range for testosterone is between 280 to 1,100 nanograms per deciliter (ng/dl).  However, low testosterone in men is considered to be below 300 ng/dl.   When a man has a low level of testosterone, it may be referred to as low testosterone, low T, hypogonadism and/or testosterone deficiency. 

Obesity’s role in low testosterone

Men who gain weight will also be gaining in the number of fat cells found in their body. This increase in fat cells has been found to have a direct link in leading to low testosterone levels in men.  Here how it works: A 2013 study found that fat cells have a high amount of an enzyme called aromatase. Aromatases are molecules that speed up chemical reactions and one of their jobs is to make the hormone estrogen out of testosterone.  Estrogen is the main sex hormone found in women.  Men actually need some estrogen but in much smaller amounts than women.

Extra weight gain in men means extra fat tissue, which very likely will accumulate in his abdomen or belly known as abdominal fat.  The more abdominal fat tissue a man has the larger amounts of aromatoses that are made converting his testosterone into the female hormone estrogen.  Not a good thing for men. As this happens, his testosterone levels will drop precipitously.

Estrogen has another trick it plays on men’s testosterone levels. As more estrogen is produced, it signals a man’s hypothalamus and pituitary gland to reduce testosterone production. Normally in men, testosterone is made by the testes whenever certain regions of the brain (hypothalamus and pituitary gland) receive signals telling them more testosterone is needed. These glands will then send a chemical message to the testes which respond by increasing the production of testosterone. But in obese men, this signal has been taken over and thwarted by the higher amounts of estrogen he is producing.

Besides the numerous side effects mentioned earlier, low testosterone levels can result in reduced motivation in men.  They feel fatigued with little get up and go to work out.  The less men exercise without making dietary changes, the greater likelihood of gaining weight. Overtime, men will find themselves dealing with significant health issues.

Weight loss key to boosting testosterone levels

The best solution for raising testosterone levels in obese men is to lose weight. In fact, results from a 2012 study of the Endocrine Society found that losing weight can reduce the prevalence of low testosterone levels in overweight to obese middle-aged men with prediabetes by almost 50%.   

As men lose weight, they also lose fat tissue helping interrupt the vicious cycle of estrogen production that negatively influences testosterone production. The best way for men to lose weight is to adopt a healthy eating plan by meeting with a registered dietitian who can create an individualized meal plan and to increase regular exercise focusing on aerobic and resistance training. 

As weight is lost, there will be improvements not only in healthier testosterone levels but also in day-to-day functioning. As an example, one study found that men who lost 15% of their body weight experienced a significant improvement in erectile dysfunction.

Any man who is overweight or obese should discuss with their healthcare provider the best weight loss strategy to follow to help elevate their testosterone levels. The sooner it’s addressed, the sooner a man can get back to living a full life.

David B. Samadi, MD, Urologic Oncology Expert and Robotic Surgeon located at 485 Madison Avenue on the 21st floor, New York, NY – 212-365-5000.  Follow Dr. Samadi at www.samadimd.com,  www.prostatecancer911.com, and www.roboticoncology.com.