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Weight loss resulting from gastric bypass reversed hormonal changes in obese men

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Roux-en-Y gastric bypass surgery was associated with improvements in testosterone levels and ratings of sexual quality of life among morbidly obese men.

Researchers studied 64 morbidly obese men who were enrolled in the Utah Obesity Study (mean weight, 333 lb; mean BMI, 46.2). Twenty-two underwent Roux-en-Y gastric bypass and 42 served as controls. The researchers measured weight, BMI and hormone levels at baseline and two years later and asked men to complete a questionnaire to assess quality of life.

“We found that lower testosterone levels and diminished ratings for sexual quality of life were correlated with increased BMI. [Men] who lost weight through bariatric surgery experienced a reduction in estradiol levels, an increase in testosterone levels and an increase in ratings of sexual quality of life,” Ahmad Hammoud, MD, researcher at the Utah Center for Reproductive Medicine, said in a press release.

After two years, men who underwent gastric bypass experienced significant decreases in BMI (–16.6 vs. –0.46 for controls) and estradiol as well as increases in both free and total testosterone.

Testosterone levels ≤47 pg/mL were reported in 29.4% of morbidly obese men (BMI ≥50) and 15.2% of obese men (BMI 40-50). A weight increase of 10 lb was associated with a reduction in free testosterone of 1.35 pg/mL and reduction in total testosterone of 11.79 ng/dL.

Based on the questionnaire responses, sexual quality of life was also improved following gastric bypass, according to the researchers. There was a negative correlation with difficult sexual performance and low sexual desire with free (r=–0.273; P=.038) and total testosterone (r=–0.267; P=.042).

These results indicated an association between sexual quality of life and hormonal measures independent from weight, according to the study. Because this relationship was confounded by biopsychosocial aspects of obesity, further studies are required to determine a cause and effect relationship.

Hammoud A. J Clin Endocrinol Metab. 2009;doi:10.1210/jc.2008-1598.