Testosterone Therapy Helps Trim Men's Waistlines

Previous studies of testosterone replacement therapy (TRT) have shown changes in body composition, usually in the form of increased lean mass and decreased fat mass.  Farid Saad, from Bayer Pharma (Germany), and colleagues reviewed data in a prospective registry of middle-age and older men, mean age 60.6 years, who received TRT for at least 2 years and for as long as 5 years. More than half of the patients had 4 years of follow-up.  The objective was to determine the long-term effects of normalization of testosterone levels in the men. Standard treatment was 1,000 mg initial dose, followed 6 weeks later by 1,000 and then 1,000 mg every 12 weeks after.  The baseline testosterone level averaged 287 ng/dL. Baseline weight averaged 236 lbs., and 95% of the men had a baseline body mass index (BMI) >25, including 71% of men who obese (BMI 30 to 40) or morbidly obese (≥40). The men had a median waist circumference of 42.2 inches Similarly to weight distribution, 4% of the men had a waist <37 inches, and 68% had a waist circumference ≥40 inches thick.  Testosterone levels normalized (≥350 ng/dL) within 6 to 9 months and remained stable throughout follow-up. Annual measurements showed that testosterone levels significantly exceeded baseline values (P<0.0001) beginning at 12 months and continuing to the end of follow-up. Similarly, body weight declined significantly within 12 months and continued to decline for as long as 5 years.  As well, weight declined significantly between annual measurements, beginning at year 2.  More than half of the men (53%) lost at least 33 lbs., and almost a third lost 44 lbs. or more weight. Similarly, 86% of the men had a least a 2-inch reduction in waist circumference, and 46% dropped 6 inches or more. Commenting that: ""I don't know many treatments where more than 90% of patients respond in a positive way to the treatment," the lead study author emphasizes that: ""There is no evidence of an increased risk of prostate cancer in testosterone-treated men.”