Testosterone Concerns in Obese Men – Part 1

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM; Carrie Lam, MD

Obesity and testosterone concerns in menThere are many ways to define the term ‘obese’. You could say it is when your body mass index (BMI) is over thirty. You could say it is when someone is abnormally fat. You could even say that, for example, it is when your body has too much visceral fat. To put it bluntly, obesity is when you carry around so much fat that it affects your health – and not in a positive manner. Obesity, in fact, not only leads to a number of health issues but could also lead to your death. Among the many issues faced by obese men are testosterone concerns, and we will be taking a look at that in a moment. Let’s first take a look at the issue of obesity and why it is a concern.

Testosterone Concerns

Why are men increasingly becoming obese? First, let us take a look at what the statistics say. Currently, in the U.S., it is estimated that two out of every three people are overweight or obese. One in three adults is considered obese. Seventy-four percent, that is almost three-quarters of the male population in the United States, are either overweight or obese. Furthermore, out of this percentage, a further four percent have what is considered extreme obesity. This is when your body weight is a hundred pounds or more over your ideal weight.

This leads to the question of WHY? For the most part, obesity is a lifestyle issue or due to other relevant factors, although, in a few, it is the result of their genes, although this is not really an excuse for the most part.

Your genes

It is estimated that approximately every one in six people carries a fat mass and obesity-associated gene. This gene is commonly referred to as the FTO gene. Of the people that are affected, it is estimated that about seventy percent face the likelihood to become obese. These people, according to research, have higher than average levels of the ghrelin hormone, a hormone that makes you feel hungry. The FTO gene tends to change the way your brain responds to this hormone and food images in the parts of the brain that are linked to eating and reward.

Besides eating more, people with this gene also tend to favor food higher in calories even before overweight and obesity become an issue. Where people have a double copy is this gene, i.e. two, one from each parent, the impact is doubled.

Of course, it is easy to blame weight gain or obesity on a faulty gene. Although it may be a contributing factor for a small percentage of the obese population, it is not, however, the major contributor to obesity in the larger sector of the obese population.

Certain medications

Certain medications tend to promote weight gain. Among these are included:


It would seem that people taking antidepressants stand a 58 percent greater risk of becoming obese. Certain antidepressants are so effective in promoting weight gain that they are prescribed to older, underweight people and those who have lost weight due to the occurrence of AIDS.

However, weight gain when on antidepressants is not always directly due to the medication itself. Often, people with depression tend to lose weight due to depression, and once on medication, feel better, eat more, and pick up weight. Overeating because of depression is often a psychological response in order to feel good, and thus not directly linked to the medication itself. One can not thus summarily blame weight gain when being treated for depression on the medication. Other factors may contribute, although certain medications do seem to promote the condition.


Testosterone concerns and medicationsCorticosteroids are easily taken up into the system. Although they are powerful anti-inflammatory drugs, they could cause elevated blood sugar levels, insulin resistance, and thus promote the storage of fat – leading to weight gain.

Beta Blockers

Beta blockers are medications typically prescribed for hypertension and to prevent heart attacks, but they only count for a gain of between two to four pounds when the medication is initially administered. Beta blockers decrease your metabolic rate by approximately ten percent when first taken. They may also have a negative effect on the energy metabolism process.

Newer generation beta blockers seem not to have this effect, however.


People who regularly use antihistamines to control hayfever and allergies tend, on average, to weigh more than those who do not. The reason is that antihistamines target your body’s H1 histamine receptor. Besides playing a role in your body’s allergen response, the H1 histamine receptor also plays a role in your brain’s circuitry, most especially the part that has to do with your appetite. When this receptor is suppressed, your appetite is stimulated, leading to possible obesity in the long-term.

Antipsychotic drugs

The use of certain antipsychotic drugs may result in elevated cholesterol levels, diabetes, and a dramatic increase in weight gain. These are all aspects of metabolic syndrome.

These antipsychotics seemingly cause elevated levels of AMP-kinase, a brain enzyme that blocks your H1 histamine receptors. This results in a larger appetite and thus weight gain.

Many of these drugs also have a negative impact on your blood sugar levels, which, in turn, could lead to insulin resistance and ultimately type 2 diabetes – which could also potentially lead to weight gain.

Medication for diabetes

Insulin, commonly used by diabetics to stabilize blood sugar levels, is an anabolic hormone that promotes the storage of protein, glucose, and fat. The only way to counteract this is by regular exercise and diet. Additionally, certain oral medications used by diabetics stimulate the pancreas to secrete insulin which may encourage weight gain.

Ironically, many of the medications that may contribute to weight gain are used for treating certain conditions that are often the result of obesity.

Sleep as a factor

Research indicates that lack of sleep is a contributing factor when it comes to obesity. Sleep deprivation results in the production of ghrelin, an appetite-stimulating hormone, as well as a lowered leptin production. The hormone leptin works at suppressing your appetite. Those who have a chronic condition including adrenal fatigue with insomnia may fall into this category.

Foods causing a disruption in the endocrine system

Studies suggest certain foods act as endocrine disruptors, resulting in a fatty liver, metabolic syndrome, and an altered lipid energy metabolism. Sugar, for example, is made up of fructose and glucose. While glucose can be metabolized by every cell in the body, the same can not be said about fructose. Fructose is metabolized in the liver, and, when the glycogen levels become too high, is stored as fat. The liver, in time, becomes insulin resistant, resulting in obesity, insulin resistance (and possibly diabetes), and metabolic syndrome, among others.

Too little physical activity

Testosterone concerns in obese man with sedentary lifestyleObesity is on the rise in richer as well as middle-income societies globally. Lack of physical activity has been cited as a possible cause. The problem seems to be caused by people not doing the physical activities that burn the number of calories consumed, resulting in excess calories being stored in the form of fat.

Physical activity does not imply vigorous exercise, however. Instead, it refers to any activity that burns calories. This includes walking and doing your chores. Those with debilitating conditions such as chronic fatigue, fibromyalgia and adrenal fatigue with limited physical energy will be particularly at risk.


Obesity due to diet is in many cases due to bad eating habits, i.e. where unhealthy, kilojoule-laden food is regularly consumed without adequate exercise. The ‘quick meal’ and processed foods rich in fat and additives has become the norm in many societies.

Unhealthy food choices include the following:

  • High-fat fast foods
  • Large food portions
  • Not eating enough fruit and vegetables
  • Eating refined carbohydrates
  • Consuming too much alcohol
  • Consuming foods high in sugar
  • Eating fast foods and processed foods
  • Eating as a means of making yourself feel better

Common Health Issues Related to Obesity and Testosterone Concerns

Obesity in men may cause more health concerns than in women. Among the most common health concerns are that it may:

  • Increase the risk of premature death
  • Increase the risk of insulin resistance and diabetes
  • Increase the risk of metabolic syndrome
  • Increase the risk of certain cancers, e.g. prostate cancer
  • Cause sleeping problems
  • Increase your risk of developing kidney stones
  • Play a role in erectile dysfunction
  • Lower sperm count and thus influence fertility
  • Lower testosterone levels

Role of Testosterone in Men

Testosterone concerns in production stagesMales start producing testosterone shortly after birth. Thereafter, levels rise, leveling off during the late teens, and decreasing after about thirty years of age. Although this is normal, obesity plays a large role in a lowered testosterone production.

Testosterone, in males, plays a very important role in protein development, thereby affecting just about every function in the male body, including the development of his sexuality and certain behaviors. The different testosterone functions in men include:


When a male reaches puberty, testosterone levels rise resulting in pubic hair, the growth of the penis and testicles, encouraging the growth of pubic, facial, and body hair, resulting in a deepened voice, and enhancing muscle growth. This is the period during which males become aware of their sexuality and begin developing sexual urges. Lower testosterone levels, however, reduce the desire for sex.

Muscle, bone, and fat development

Testosterone plays an important role in the development of male muscles, and thereby, strength. It does this by encouraging the number of neurotransmitters produced that influence tissue growth. It also plays a vital role when it comes to the body increasing its growth hormones, allowing men to build more muscle, usually by means of exercise.
Besides the role it plays in the tissue, specifically muscles, it also has an important function in bone density, as it aids in sending messages to your bone marrow, encouraging the production of red blood cells. Men who have lower testosterone levels tend to develop bone fractures easier.

Testosterone is important for the metabolization of fat, which is why obese men have less of this hormone. Conversely, fat causes lower testosterone production, while lower testosterone levels encourage obesity.

The endocrine system

The male endocrine system consists of the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands , pancreas, and testicles. This system of glands is responsible for a number of vital functions within the body, amongst them the production of hormones responsible for growth and development, reproduction, mood, and sleep. Testosterone is one of the most important hormones in the male body. When complications arise in the endocrine system, the production and function of this hormone are compromised, resulting in a number of health issues.

Read Part 2 | Part 3

© Copyright 2018 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

There is much you can do address your testosterone concerns from a holistic point of view. By changing your diet, adding testosterone boosting food to your diet, addressing your stress issues, and twenty minutes of high-impact exercise a day does wonders.

testosterone concerns