Testosterone and obesity

Obes Rev. 2015 Jul;16(7):581-606. doi: 10.1111/obr.12282. Epub 2015 May 15.


Testosterone is a key hormone in the pathology of metabolic diseases such as obesity. Low testosterone levels are associated with increased fat mass (particularly central adiposity) and reduced lean mass in males. These morphological features are linked to metabolic dysfunction, and testosterone deficiency is associated with energy imbalance, impaired glucose control, reduced insulin sensitivity and dyslipidaemia. A bidirectional relationship between testosterone and obesity underpins this association indicated by the hypogonadal-obesity cycle and evidence weight loss can lead to increased testosterone levels. Androgenic effects on enzymatic pathways of fatty acid metabolism, glucose control and energy utilization are apparent and often tissue specific with differential effects noted in different regional fat depots, muscle and liver to potentially explain the mechanisms of testosterone action. Testosterone replacement therapy demonstrates beneficial effects on measures of obesity that are partially explained by both direct metabolic actions on adipose and muscle and also potentially by increasing motivation, vigour and energy allowing obese individuals to engage in more active lifestyles. The degree of these beneficial effects may be dependent on the treatment modality with longer term administration often achieving greater improvements. Testosterone replacement may therefore potentially be an effective adjunctive treatment for weight management in obese men with concomitant hypogonadism.

Keywords: Adipose; androgen; metabolism; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adipose Tissue / drug effects
  • Adult
  • Hormone Replacement Therapy*
  • Humans
  • Hypogonadism / blood
  • Hypogonadism / complications*
  • Hypogonadism / drug therapy
  • Male
  • Obesity / blood
  • Obesity / etiology
  • Obesity / prevention & control*
  • Receptors, Androgen / therapeutic use*
  • Risk Factors
  • Testosterone / blood
  • Testosterone / deficiency*
  • Testosterone / therapeutic use


  • Receptors, Androgen
  • Testosterone