Does Testosterone Help You Lose Weight?

Back in his military days, at 33, Brian Yoshimura might never have considered testosterone replacement therapy (TRT) as a solution for weight loss, let alone dropping pounds at all. He was ripped and spry. “But 10 years later, at 43, I weighed 285 pounds, and my knees almost gave out just walking to my car,” he says.

Even though Yoshimura still exercised four to five days a week, he struggled to finish a 20-minute workout. “I had to chug energy drinks and coffee just to make it through the day,” he says. It wasn’t until he took a test through Hone that he discovered his testosterone levels were below where they should be for his age.

And there are millions of guys like Brian. Maybe even you.

Back when your metabolism seemed on fire, no matter what you ate or did, you still sported a six-pack. Fast forward and it’s harder to muster the energy to get to the gym, let alone manage your growing waistline.

While lots of factors can make it harder to lose weight or maintain it with age, there’s one that’s often overlooked: low testosterone.

Does TRT Help With Weight Loss?

Testosterone replacement therapy can help men lose weight if low testosterone levels are a primary reason for their weight gain. A 2021 review and meta-analysis of 16 controlled trials found that obese men who were on TRT gained two kg of lean body mass (read: muscle), and helped reduce both waist circumference and body mass index (1).

Long-term TRT in obese men contributed to prolonged weight loss, with patients losing 20% of their baseline weight (about 50 pounds) on average, without added risk for mortality of heart issues (2).

However, TRT generally isn’t prescribed solely for weight loss. According to the American Urological Association, TRT is typically used to treat symptoms related to erectile dysfunction, depressive symptoms, anemia, and bone mineral density. If any weight loss occurs on TRT, it’s a bonus related to relief from other symptoms (3).

Low testosterone levels and weight gain

The average American male experiences a decrease in testosterone at a rate of about 1 to 2 percent per year, beginning around age 30 to 35 (4).

“This means that by age 50, you can be down as much as 20 percent. Some men notice it, others don’t, and some just chalk it up to the inevitability of aging,” says Richard Foxx, M.D., a physician who regularly treats men with low testosterone.

A study published in the International Journal of Environmental Research and Public Health found that middle-aged men see weight gain as an unavoidable consequence of life (namely, due to family and work commitments), and those interviewed felt helpless and despondent (5).

But the older generations aren’t the only ones experiencing low testosterone, and recent research indicates that the decline might even be skewing younger. A 2021 study found that about 20 percent of adolescent and young adult males (ages 18 to 29) had a testosterone deficiency (6).

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How Testosterone Affects Body Composition

Testosterone helps regulate metabolism and body composition, and if you’re deficient, you’re likely to gain weight and experience fatigue. Men with low testosterone are more likely to develop a gut—or male-pattern obesity, as Foxx calls it. For men diagnosed with hypogonadism (low testosterone), TRT can support weight loss and a healthier lifestyle.

TRT and fat loss

TRT can help men lose their belly fat. A 2015 review of 411 obese men with low testosterone found a reduction of 5-10 BMI points and 10-14 cm in waistline.

But why does restoring testosterone levels result in fat loss? Weight gain and low testosterone have a bidirectional relationship, meaning that low testosterone can cause weight gain—and excess fat—especially visceral, or belly, fat—can also cause low testosterone.

Visceral fat raises your risk of serious medical issues such as heart disease, type 2 diabetes, stroke, and even reduced cognitive function, according to a 2023 study published in The Lancet (7). What’s more, those extra fat cells don’t just sit there looking, well, fat. They actively secrete chemicals into your body, most notably an enzyme called aromatase, which converts testosterone into a type of estrogen.

“If your estrogen is too high, it acts on the pituitary gland—the one that controls your sex hormones and thyroid—and tells it to stop producing testosterone,” Foxx says. “This hormonal imbalance makes it even harder to lose weight. It’s a chicken and egg situation—are you overweight because you have low T, or do you have low T because you’re overweight?”

TRT and muscle gain

In a 2018 review, 411 men receiving intramuscular TRT experienced a 6% gain in lean muscle mass. TRT activates androgen receptors to trigger muscle growth, as well as increasing levels of IGF-1, a muscle-stimulating hormone (8). 

Two of the primary side effects for low T are fatigue and sarcopenia—loss of muscle mass—both of which can lead to weight gain.

“If you lose muscle, you lose your ability to burn as many calories as you did before, because muscle is more active tissue than fat,” Foxx explains. “Low testosterone also decreases your drive to go out and do things such as working out, which also contributes to weight gain.”

Does Losing Weight Increase Testosterone Levels?

If you start to lose weight, your testosterone levels will also naturally begin to rise. Why? As body fat decreases, the amount of aromatase enzyme is reduced. This reduction leads to a higher testosterone-to-estrogen ratio, allowing testosterone levels to increase.

Better yet—many weight loss strategies, like resistance training, can also stimulate testosterone. That’s two health benefits for the same hour at the gym—not too shabby.

Testosterone and Lifestyle

Modern day habits are mostly to blame for low testosterone levels, and factors such as sedentary lifestyle, obesity, stress, poor sleep, and alcohol consumption have been shown to have a direct impact on the levels of testosterone in your body (9, 10).

It’s important to note that TRT on its own isn’t a panacea. But when TRT is combined with exercise and other healthy habits, it can help testosterone-deficient men get back on track.

“It takes about three to four weeks to really feel the effects of the treatment, at which point you’ll regain your motivation to exercise and go out and do things,” Foxx says. “As you exercise, your muscle mass will go up and your weight will go down, and most of all, your quality of life improves drastically.”

So are you a candidate for TRT? Get an at-home assessment and find out. You have nothing to lose (well, except your gut) and years to gain. “The human species is the only animal that outlives its reproductive years, but that is no reason to accept the condition you’re in if you can safely prevent it,” Foxx says. “You can absolutely be in your 70s and still be vital and alert and energetic.”

Yoshimura’s at-home assessment showed his levels were below the 300 ng/dL that the American Urologic Association says should be considered for treatment. “It came back at 224ng/dL, and I started TRT,” he says.

In one year, Yoshimura lost 50 pounds and 10 inches from his waist. “I feel like a completely different person,” he says.

Fast, Easy, Affordable

Hone’s at-home testosterone assessment is the simplest way to uncover whether your levels are low. If you qualify for treatment, TRT can be sent right to your door.  

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