CHICAGO – Testosterone replacement therapy may provide a pharmacologic alternative to bariatric surgery in severely obese hypogonadal men.
Mean body mass index in 46 hypogonadal men with grade III obesity dropped from 41.9 to 33.6 kg/m2 while they were receiving testosterone undecanoate at 1,000 mg by intramuscular injection every 12 weeks for up to 6 years, Farid Saad, Ph.D., reported at the joint meeting of the International Congress of Endocrinology and the Endocrine Society.
The subjects, with a mean age was 60 years, were culled from two prospective registries totaling 561 men with a serum total testosterone of 12.1 nmol/L or less along with symptoms of testosterone deficiency. These 46 men were selected for the analysis because a BMI of 40 kg/m2 or more is an indication for bariatric surgery, and the impact of testosterone replacement in hypogonadal men with grade III obesity has not previously been studied, explained Dr. Saad, director of scientific affairs at Bayer Pharma in Berlin.
Mean body weight in this group decreased from 129 to 103 kg. Weight loss grew over time: The men averaged a 2.7% reduction in body weight after 1 year of testosterone therapy, 7.3% after 2 years, 10.9% after 3 years, 14.1% after 4 years, 17.4% after 5 years, and a 20.8% decrease from baseline body weight after 6 years of therapy.
Mean waist circumference shrunk from 118.4 cm at baseline to 106.5 cm.
On the basis of these long-term results, testosterone replacement therapy appears to be an effective means of achieving sustained weight loss in severely obese hypogonadal men, he concluded.
The registry study was funded by Bayer Pharma, which markets testosterone undecanoate as Aveed.