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The Link Between Obesity and Low Testosterone (Low T)

The link between obesity and low testosterone levels has been well established over the years. In addition, researchers have also documented links between lower testosterone levels and the obesity related diseases of diabetes, high blood pressure, and high cholesterol associated with metabolic syndrome.

How Does Obesity Affect Testosterone Levels?

Obesity causes hypogonadism or testosterone deficiency in men in two ways. First, fat cells lower testosterone levels by transforming the hormone into estrogen. The second way obesity lowers testosterone is by decreasing the levels of SHBG (sex hormone binding globulin), a protein that is responsible for carrying testosterone in the blood stream. In fact, studies have shown that obese men over 40 years of age are two and a half times more likely to suffer from Low T than their healthy weight counterparts. One study also noted that men with the obesity related diseases of diabetes or high blood pressure are nearly twice as likely to have lower testosterone.

What Are The Health Risks of Having Low T?

Men with a testosterone deficiency are at higher risk of cardiovascular disease and hardening of the arteries or atherosclerosis. Low testosterone has a causal link with metabolic syndrome, which greatly increases the risk of stroke and heart attacks in sufferers.

Men with Low T are more likely to suffer from depression, energy imbalance, and poor blood sugar control due to insulin resistance. Hypogonadism is also a directly association with erectile dysfunction and infertility.

How Can I Increase My Testosterone Levels?

In healthy weight patients, doctors have seen promising success in prescribing a testosterone replacement treatment.

However, for obese patients, weight loss is primarily prescribed. Unfortunately, due to the metabolic issues associated with lower testosterone, patients rarely achieve the 15% body weight reduction necessary to increase testosterone levels, even with weight loss medications. The good news is patients with a body mass index (BMI) of 35 or greater may be candidates for gastric sleeve surgery.

Gastric Sleeve Surgery for the Treatment of Low Testosterone

Two separate studies have shown that the rapid weight loss achieved through laparoscopic sleeve gastrectomy or gastric sleeve surgery have an immediate and lasting effect on testosterone levels in obese male patients.  

A Stanford University study presented to the American College of Surgeons showed that obese men with low testosterone who had sleeve gastrectomy surgery saw a significant increase in their testosterone levels within 12 months of surgery.

A second study from the Cleveland Clinic showed similar results that lasted up to five years after bariatric surgery. According to the study, men who had bariatric surgery showed a nearly 85% increase in total testosterone, where the group undergoing medical therapy for Low T only showed a 10% increase.

“The take home message is that if you are an obese man with low testosterone your therapy should be weight loss, not testosterone replacement, and a successful way to achieve meaningful weight loss is through a bariatric operation,” Dr. Morton, coauthor of the Stanford University study, said.

Wondering if gastric sleeve surgery might help you with Low T? Schedule a consultation with Dr. Bagshahi at Bagshahi Bariatric and General Surgery to find out if you are a candidate.