Most guidelines recommend weight loss by diet/exercise as the first intervention to help men achieve optimal testosterone levels. However, it requires a large amount of weight loss that is maintained over time. In most cases this is rarely achieved by lifestyle interventions. Bariatric surgery is currently the main obesity treatment modality that results in a large amount of weight loss with decent weight loss maintenance. However, bariatric surgery is an invasive and expensive procedure, with risk for complications.
Considering the high prevalence of Low-T in men with obesity, a more practical and sustainable obesity treatment for men is testosterone therapy. In contrast to weight loss achieved by diet/exercise and bariatric surgery, TRT significantly preserves both muscle and bone mass. Further, TRT may increase the motivation and ability of men to adhere to diet/exercise programs.
Prescription weight loss medication can be a great standalone obesity treatment with positive testosterone benefits. It can also be used as an adjunct therapy with Low-T treatment for those men that have a significant amount of weight to lose to reach their optimal health.
Approximately 70% of American adults have obesity or overweight. Having obesity or overweight is a serious health issue associated with some leading causes of death, including heart disease, stroke and diabetes, and is linked to an increased risk of certain types of cancer. Losing 5% to 10% of body weight through diet and exercise has been associated with a reduced risk of cardiovascular disease in adult patients with obesity or overweight.
Semaglutide works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain that regulate appetite and food intake. The dose is increased gradually over 16 to 20 weeks to the max dose of 2.4 mg once weekly to reduce gastrointestinal side effects.
The most common side effects of semagluride include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, belching, hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), and gastroesophageal reflux disease (GERD).
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