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+++++++++++++++++++ + + +++++++++++++++++++ WEIGHT LOSS +++ +++ Testosterone The Obese Male and By Jeannine M. Cobb, M.D., FACOG, Diplomate, American Board of Bariatric Medicine T HE MEDICAL COMMUNITY has long understood that lower testosterone levels in men affect their muscle strength, muscle mass, energy, sexual function and general feelings of well-being. Research has now unquestionably shown that obese men have a much higher likelihood of lower testosterone levels and, further, that bringing those levels to normal can assist with weight loss. Obesity with elevated body fat percentage can cause secondary hypotestosteronism — due to altered sex hormone-binding globulin — increased estrone production and more active aromatase inhibitor. This can alter the conversion of total testosterone to free testosterone. Adrenal fatigue can also be a component of obesity. Moderate weight loss and reduction of body fat percentage can signifi cantly improve this condition. Addressing the issue of testosterone levels can be somewhat diffi cult given our societal images regarding sexual issues. However, obese males who seek out a bariatri- cian for assistance have, perhaps unwittingly, opened the door to the subject. Low testosterone levels can be discussed with patients as a means of aiding in their weight loss. Once the issue is addressed, the bariatrician can easily move into the other benefi ts of treating low levels. At Medi-Weightloss Clinics, bariatricians have found that once they initially deal with the issue, patients are very willing to be tested and treated and then discuss the full ramifi cations of the issue and necessary treatments. Treatment of lower testosterone levels at Medi-Weightloss Clinics begins with simple blood tests. When bariatricians discuss results with patients, they are careful to point out all of the common benefi ts of treatment, to include the pos- sible assist to their weight loss program. Patients are then referred to a compound- ing pharmacist, who interviews patients and then compounds topical creams made specifi cally for each patient based on his individual history a nd l a b s . Although anecdotal in nature, the expe- rience indicates marked improvement in energy levels, feeling of well-being and the weight loss program. Medi- Weightloss Clinics is not in a position to measure effect on muscle mass or strength, or even improvement in sexual functioning. Because low testosterone levels are relatively easy to predict in obese male patients (and then easy to diagnose through simple blood tests), and as the benefits are great, with minimal or nonexistent side effects, Medi-Weightloss Clinics feels that all patients who fall within the broad parameters for testing should be informed about the potential for low testosterone levels and given the opportunity to be tested and treated. For further information or scientific citations and documentation on the subject, contact Dr. Cobb at Medi-Weightloss Clinics, Andover by calling (316) 733-8505. ■ 10 | Greater Kansas MD NEWS MDNEWS.COM