Should low testosterone levels be considered an additional criterion for bariatric or weight-loss surgery? This question has emerged following a local study conducted by a bariatric surgeon, which was published in an indexed medical journal.
The study reveals that six out of ten obese patients who visited the surgeon exhibited low levels of testosterone, the primary male hormone.The surgeon, who is the principal author of the study, suggests, “Given the findings in the first such study from India, I feel we should address the query about the inclusion of testosterone deficiency as an additional qualification for bariatric surgery.”
For decades, low testosterone levels have been associated with obesity. Scientists explain that fat cells metabolise testosterone into the hormone estrogen, leading to a deficiency of the male hormone. Furthermore, inadequate testosterone levels can impair blood sugar conversion, eventually leading to diabetes.
Published in ‘Obesity Surgery’, an indexed journal from Springer-Nature, the study examined 134 males aged between 18 and 30, all of whom had a BMI (body mass index) exceeding 32.5 kg/m². The researchers recorded their BMI, total and free testosterone levels, and clinical features such as gynecomastia (an increase in breast gland tissue in males), hypogonadism (failure of the testes to function properly), and thinning of pubic and armpit hair.
The study discovered that 60% of the patients had low testosterone levels, while another 20% had borderline counts. The findings indicate a decreasing trend in testosterone levels among obese youths as BMI increases.
The surgeon noted that some obese patients wear jackets even in summer due to concerns about the size of their breasts. Additionally, many parents are worried about the impact of excessive weight on their sons’ physical development. “The actual incidence of hypotestosteronemia (testosterone deficiency) and its manifestations in young adults may be significantly higher than what is reported in the literature. We need to study this trend in detail,” the doctor remarked.
Testosterone’s importance extends beyond its role as a male sex hormone; it also plays a crucial part in emotional wellbeing. Its levels influence cognitive functions and the risk of depression in both men and women. “Testosterone is important for enthusiasm, commitment, and compliance. When there is a lack of commitment or compliance, low levels of testosterone might be at play,” explained the doctor.
Considering the hormone’s significance, the study proposes that testosterone deficiency should be included as a criterion for bariatric surgery, which encompasses various weight-loss operations. This suggestion underscores the need to address hormonal imbalances in the treatment and management of obesity, potentially enhancing the effectiveness of weight-loss interventions and improving the overall health outcomes for obese individuals.
As the medical community continues to explore the intricate relationship between obesity and testosterone levels, this study serves as a call to re-evaluate the criteria for bariatric surgery and ensure comprehensive care for patients struggling with obesity and its associated conditions.
