Can Testosterone Therapy Help Men Lose Weight?

How Does Testosterone Replacement Therapy Affect Weight?

But How Does This Impact Weight?

Testosterone and weight are intimately connected, says Justin Dubin, MD, a urologist and the director of men’s sexual health at Baptist Health Miami Cancer Institute in Miami. When one of them changes, it can affect the other. “It’s a bidirectional, perpetuating cycle,” he says.

“This led to wider research on the metabolic effects of testosterone and whether TRT could in fact be used to support weight loss,” says Jeff Foster, MBChB, a general practitioner in Warwick in the United Kingdom who specializes in men’s health and researches testosterone replacement therapy.

TRT was found to have a direct effect on metabolism, Dr. Foster explains. “If your testosterone levels are low, it slows down how you utilize energy — you lose muscle and you gain fat.”

While most users will see a drop in body fat and an increase in muscle mass when they start TRT, the effects are typically much less than is seen with medications specifically indicated for weight loss, Foster says. He adds that weight loss is not one of the main reasons most people seek out TRT.

What the Science Says About Testosterone Therapy for Weight Loss

There’s good evidence showing that TRT may help men lose belly fat and improve their overall body makeup, says Foster. “But the evidence that it is used as a standalone weight loss drug is not great — because it’s not designed to do that anyway.”

Foster says this is likely due in part to testosterone’s role in building muscle, which can offset fat loss when measuring total body weight. In other words, you may not notice significant weight loss changes if you are also gaining muscle mass, he explains.

Testosterone replacement works in part by increasing metabolic rate, which is the pace at which your body typically burns calories, he says. “This supports weight loss with the same caloric intake,” he adds. “TRT is not the best choice for weight loss, but weight loss can occur due to the other anabolic effects it has on the body.”

Who Should and Shouldn’t Try It

“The best candidates for TRT are those with symptoms of hypogonadism, such as fatigue, brittle bones, poor muscle strength, low sex drive, and erectile dysfunction,” says Dr. Turek.

It’s also important to point out that while consistent use of TRT over time could help men with low T manage their weight, it works best for weight loss in conjunction with other lifestyle interventions. “TRT definitely works best when paired with a modified diet, a purposeful exercise regimen, and good sleep hygiene,” Turek adds.

• Acne or oily skin
• Fluid retention that may trigger ankle swelling
• Urinary symptoms
• Breast enlargement or tenderness
• Sleep issues, like worsening of sleep apnea
• Decrease in sperm count, which may lead to infertility
• Skin irritation with topical TRT

• Infertility
• Enlarged prostate
• Increased risk of high blood pressure
• Increased risk of blood thickening and blood clotting
• Cholesterol issues
• Worsening of heart disease
• Increase in prostate-specific antigen (PSA) level

“Not every man will need TRT, but for those who do require it, it can be a life-changing drug,” says Foster. “Too few men consider TRT because they think it’s a normal part of aging to feel tired, gain weight, and lose libido — but for a significant proportion of men, it’s due to a drop in a hormone that we can do something about.”