Does Testosterone Make You Gain Weight? How the Two Connect

Craig Primack, MD, FACP, FAAP, MFOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Hadley Mendelsohn

Published 05/24/2024

Does testosterone make men gain weight? Nope, it doesn’t! In fact, the opposite is true: High testosterone levels seem to help stave off weight gain in men.

One study found that lower percentages of body fat and higher lean body mass levels (i.e. the weight of your organs, skin, bones, body water, and muscles) were linked with elevated testosterone levels in men. So, it appears to be key in helping men maintain a healthy weight.

Still, the relationship between low testosterone and weight gain can be complicated and worth delving into in more detail. Ahead, learn more about what testosterone is, and how it plays a role in both weight management and muscle building. Then, find out more ways to help boost testosterone if you think you may have a deficiency, including replacement therapies and other natural options.

Testosterone is a sex hormone that’s produced in the testicles (and the ovaries in women, though we won’t dive into all that since it’s not linked to body weight in women). Testosterone production is essential to male growth and development.

Among other things, healthy levels of testosterone help:

  • Regulate sex drive

  • Contribute to bone density

  • Distribute fat tissue

  • Build muscle mass and strength

  • Produce red blood cells and sperm

  • Support facial and body hair growth

Yes, it can. This happens because the hormonal imbalance can lead to increased fat storage, muscle loss and metabolic interruptions. We’ll break down the details of each below.  

Increased Fat Storage 

As one medical article explains, people with obesity tend to have reduced testosterone levels because of the insulin resistance associated with excess weight. Basically, insulin helps keep blood sugar levels normal, and when it gets thrown off, your body starts to store that surplus of sugar as fat, which then leads to weight gain.

Insulin resistance can also lead to a decrease in the protein that binds with testosterone, which then suppresses the reproductive system. It’s a bit of a chicken-or-egg situation, but the leading belief is that this is what causes a vicious cycle wherein low levels of testosterone (low-T) leads to further weight gain and metabolic issues, and visa-versa.

In addition, one study has linked belly fat in particular to lower levels of testosterone. This is likely because belly fat contains higher levels of the enzyme responsible for converting testosterone into estrogen, which, in excess, suppresses T levels.

Decreased Muscle Growth and Strength 

Having a testosterone deficiency can also lead to a loss in muscle mass and strength. This is because testosterone binds to androgen receptors (a sex hormone), which then signals your muscle fibers to stay intact. As muscles become weaker, people can develop mobility issues and gain weight.

In other words, testosterone helps promote muscle growth and maintenance.

Weakened Metabolism 

Muscles are known to burn more calories than fat, so having more muscle can also help with weight loss. Testosterone plays a role in metabolism function in that normal levels help break down fat, burn more calories, and maintain muscle mass. It’s all connected! 

Another, smaller study looked at 33 men with a high prevalence of hypogonadism after they had bariatric surgery to see how weight loss and low t were correlated. Hypogonadism is a condition where the sex glands — testes in men and ovaries in women — produce very little or no sex hormones, which then interrupts the development of sex organs, puberty, or fertility, and leads to things like erectile dysfunction or premature ejaculation.

The study found that after 12 months of significant weight loss, testosterone levels majorly improved, as did levels of the sex hormone binding proteins and follicle-stimulating hormones. This highlights the importance of sustained weight loss in improving hormonal health in men with obesity.

  • Weight gain

  • Low libido

  • Fatigue

  • Irritability and depression

  • Breast growth

These symptoms can be both physically and emotionally frustrating to deal with, but the good news is that testosterone replacement therapy (TRT) is an effective and safe way to reverse them if you’ve been diagnosed with a deficiency.

As outlined by one scientific article, hormone replacement therapy, which is a prescription treatment, works by restoring normal glucose and fat breakdown processes. TRT can also restore hair growth, support voice deepening, enhance sexual function, improve mental well-being, and increase bone density.

It’s also a great long-term treatment option. Research shows that long-term TRT (up to 8 years) in men with hypogonadism and obesity can lead to major and sustained weight loss, a smaller waist circumference, and a lower body mass index (BMI).

Because weight management is so tied to overall health and wellness, TRT is also associated with helping to improve metabolism and cellular function, decrease inflammation, and increase motivation and energy levels, all of which lead to better heart health and heightened physical activity. So it can be a really effective treatment that ultimately helps prevent and manage other medical conditions.

According to one review, testosterone therapy is recommended for men who have been diagnosed with hypogonadism, including  those with obesity who are experiencing symptoms.

Some doctors might also recommend TRT for men who are over 65 and experiencing symptoms associated with low testosterone levels.

It’s also totally possible to have lower levels of testosterone and experience some of the symptoms (like less body hair) but not necessarily need to undergo TRT. When in doubt, get an assessment with a healthcare provider to see if they think you might be a good fit. Sometimes, a quick blood test is all it takes to get a diagnosis.

There isn’t too much known about the side effects of TRT, and more studies are needed to better understand the risks. That said, very few men who are healthy when they start treatment report serious side effects.

Still, according to one study, testosterone treatment might worsen untreated sleep apnea and affect fertility, though this usually goes away when you stop treatment. Other side effects could include:

  • Acne

  • Water retention

  • Lower sperm count

  • Higher red blood cell count

Most of these symptoms can be managed, though some are easier to treat than others. If you’re experiencing any, talk to your doctor about the best path forward.

According to a medical review, weight loss by any means, whether by diet, exercise, medication therapy, or bariatric surgery, can help reverse hypogonadism by increasing total T levels. And if you haven’t been diagnosed with hypogonadism but think you might benefit from some kind of testosterone increase, you could look into other natural remedies. Plus, because of the cyclical nature of weight gain and low testosterone levels, some other supplements that contribute to healthier habits might help out, too. Below are some tips. 

  • Consider taking testosterone supplements. Testosterone boosters don’t actually have any testosterone in them. Instead, they might work by boosting your body’s natural testosterone production. That said, there aren’t consistent scientific results backing up their ability to increase T levels. Even so, some people swear by supplements like ashwagandha and certain seed extracts, and there have been small studies linking them to improved muscle growth in men who have low levels of testosterone.

  • Try to squeeze in more strength training. Since we know that increased muscle mass helps with burning fat, working to build muscle might help jumpstart the process of increasing T levels.

  • Make sure you’re staying hydrated and getting enough sleep. These two lifestyle habits can make a big difference when it comes to hormone levels, and thus, weight management.

  • Keep stress levels in check. Things like meditation, exercise, and vitamin D (whether you get it naturally via the sun or incorporate a supplement) can help reduce stress. One study suggests that a vitamin D deficiency can lead to a testosterone deficiency, so it can’t hurt to add that to your routine.

Clearly, the effects of testosterone on men are far and wide, and having enough of it will positively impact body composition by increasing muscle strength and boosting fat loss.

Since weight and testosterone are so closely tied, it’s never a bad idea to take a holistic approach by improving diet and exercise routines. That said, it’s not always as simple or easy as that. (In fact, it usually isn’t.) There are lots of other weight management treatments available, including weight loss medications like metformin and Ozempic. And if you suspect you may need more support than that, asking a doctor about testing for hormone levels is a great next step. 

12 Sources

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  3. PubMed. “Estradiol in Elderly Men,” June 1, 2002. https://pubmed.ncbi.nlm.nih.gov/12198740/.
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Craig Primack, MD, FACP, FAAP, FOMA

Dr. Craig Primack MD, FACP, FAAP, FOMA is a physician specializing in obesity medicine.

He completed his undergraduate studies at the University of Illinois and subsequently attended medical school at Loyola University — The Stritch School of Medicine. 

He completed a combined residency in Internal Medicine and in Pediatrics at Banner University- Phoenix, and Phoenix Children's Hospital. He received post-residency training in Obesity Medicine and is one of about 7,000 physicians in the U.S. certified by the American Board of Obesity Medicine.

In 2006, Dr. Primack co-founded Scottdale Weight Loss Center in Scottsdale, Arizona, where he began practicing full-time obesity medicine. Scottsdale Weight Loss Center has grown since then to six obesity medicine clinicians in four locations around the greater Phoenix Metropolitan area.

From 2019–2021, he served as president of the Obesity Medicine Association (OMA), a society of over 5,000 clinicians dedicated to clinical obesity medicine. He has been on the OMA board since 2010, currently serving as ex-officio trustee.

Dr. Primack routinely does media interviews regarding weight loss and regularly speaks around the country educating medical professionals about weight loss and obesity care. He is co-author of the book, “Chasing Diets.”

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