Androgens: Edited by David HandelsmanAndrogens and obesityAllan, Carolyn A; McLachlan, Robert IAuthor Information Prince Henry's Institute, Andrology Australia and Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Clayton, Victoria, Australia Correspondence to Professor Robert I. McLachlan, Prince Henry's Institute, PO Box 5152, Clayton, Victoria 3168, Australia Tel: +61 3 9594 3553; fax: +61 3 9594 3558; e-mail: [email protected] Current Opinion in Endocrinology, Diabetes and Obesity: June 2010 - Volume 17 - Issue 3 - p 224-232 doi: 10.1097/MED.0b013e3283398ee2 Buy Metrics Abstract Purpose of review As testosterone levels are frequently reduced in obesity, an understanding of the relationship between serum testosterone and adiposity is necessary in the clinical evaluation of these men, in particular when considering testosterone therapy. Recent findings Population and interventional data suggest a bi-directional relationship exists between testosterone and obesity in men, with lower total testosterone and sex hormone binding globulin (SHBG) (and to a lesser extent free testosterone) levels than their nonobese peers; obesity having an impact at least as important as ageing. Abnormalities in the hypothalamo-pituitary-testicular axis are seen with increasing obesity. Weight loss in massive obesity increases testosterone levels but its role in mild–moderate obesity is unclear. Testosterone supplementation reduces total body fat in hypogonadal and ageing men although the effects on regional fat distribution are less well described. Summary Favourable changes in total body fat and regional fat distribution suggest a potential role for testosterone in obesity. However, lifestyle advice to achieve sustained weight loss should be the mainstay of management. Obese men with confirmed androgen deficiency can be offered treatment, whereas in those with low-normal testosterone levels more research is needed. Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.