Male Obesity Causes Low Testosterone With Potentially Dire Medical Consequences

Testosterone (T) is an important male sexual hormone that promotes the physical changes that commence at the time of puberty including pubic, axillary and facial hair, deepening voice, prominent Adam’s apple and increased bone and muscle mass.  Throughout adulthood, testosterone helps maintain libido, masculinity, sexuality, and youthful vigor and vitality.  The lion’s share of testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands.

There is a gradual decline in T that occurs with the aging process—approximately a 1% decrease each year after age 30. The decline will occur in most men, but will not always be symptomatic. Symptoms of low T may include one or more of the following:  fatigue, irritability, depression, decreased libido, erectile dysfunction, ejaculatory dysfunction, decreased energy and sense of well-being, loss of muscle and bone mass, increased body fat, abnormal lipid profiles. Essentially, low T can accelerate the aging process.

Obesity can have a pivotal role in the process leading to low T. Fat is not just fat—it is a metabolically active endocrine organ that does not just protrude from our abdomens in an inert state.  Fat produces pro-inflammatory factors, hormones and immune cells—including cytokines—which function to inhibit T production in the testicles and the release of hypothalamus and pituitary hormones that govern the release of T.  Low T is present in about half of obese men.   Fat has an abundance of the hormone aromatase, which functions to convert T to the female hormone estrogen (E).  The consequence of too much conversion of T to E is the potential for gynecomastia, aka breast enlargement or alternatively, man boobs.

There is a strong relationship between low T and metabolic syndrome.  Metabolic Syndrome is defined as having three or more of the following: high blood glucose levels; abdominal obesity; high fats (triglycerides); low levels of the “good” cholesterol (HDL); and high blood pressure. If we have a substantial amount of belly fat, then by definition we have insulin-resistance, a condition in which our pancreas works overtime in order to make more and more insulin to get glucose into our cells.  This is a precursor to diabetes, cardiovascular disease and all the havoc they can wreak.  Those with metabolic syndrome have a much-increased risk of cardiovascular disease and type 2 diabetes.

Bottom line:  Abdominal obesity—an accumulation of fat in our midsections—not only is unattractive from a cosmetic standpoint, but can have dire metabolic consequences that can unequivocally affect the quality and quantity of our lives. Obesity in males often promotes low levels of the all-important male hormone testosterone, which can have a number of detrimental effects on our sexuality, bone and muscle health, energy, well-being, etc.  The good news is that by losing the abdominal fat, all of the potentially bad consequences can be reversed.

Andrew Siegel, M.D. for information on Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food for educational videos on low T and a variety of other urological and wellness subjects

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