Obesity Beyond the Mirror

Brazilians are increasingly suffering from the problem of excess weight. Obesity among individuals aged 20 or older rose from 12.2% to 26.8% between 2002/2003 and 2019. Today, 61.7% of the adult Brazilian population is overweight. Between 2002 and 2003, this percentage was 43.3%. This is truly concerning and is becoming a global pandemic, potentially more severe in the long term than COVID.

Among individuals aged 18 or older, 25.9% were obese, totaling 41.2 million. One in five adolescents aged 15 to 17 was overweight.

Approximately one-third of individuals aged 18 to 24 were overweight, and among those aged 40 to 59, the proportion reached 70.3%.

Excess body fat increases the risk of testosterone deficiency in men, particularly in maturity.

While most people know that extra pounds harm health, what few men realize is that the famous “beer belly” directly interferes with hormonal balance and is linked to the onset of ailments such as diabetes, hypertension, alterations in cholesterol and triglyceride levels (fats in the blood), and joint problems.

Various factors in modern life contribute to people becoming sedentary, which favors excess weight.

At the same time that individuals expend less energy on daily tasks, the quality of food has decreased with the introduction of more caloric and easily accessible foods, such as fast food. There are two types of obesity: generalized (excess fat distributed throughout the body) and android (fat accumulation in the abdominal region). This pattern of abdominal fat, especially in the visceral (internal) region, is a significant facilitator of diseases such as diabetes, hypertension, and alterations in cholesterol and blood fats.

Men and women suffer from the effects of obesity, but the repercussions on sexual health differ between genders. The explanation lies in the fact that fat tissue cells—specifically adipocytes—produce an enzyme called aromatase, which can convert male hormone (testosterone) into female hormone (estrogen).

This can cause obese men to experience physical changes such as the development of breast tissue (gynecomastia). Furthermore, excessive estrogen acts on the hypothalamus-pituitary axis, inhibiting testosterone production. With this vicious cycle established, an obese man can develop a hormonal deficiency, known as hypogonadism. Due to being obese, an individual has 2 to 2.5 times higher risk of testosterone deficiency, a condition that tends to worsen with age, especially after 40.

When hypogonadism is solely related to obesity, weight loss is necessary for resolution. However, depending on clinical symptoms and laboratory tests, hormone replacement may be required to achieve this goal.

Undoubtedly, testosterone deficiency caused by excess weight associated with aging makes hormone REPLACEMENT fundamental; otherwise, this vicious cycle is not corrected.

Hormone replacement helps reduce abdominal fat, in addition to alleviating other symptoms of male aging, such as lack of physical vigor, loss of bone and muscle mass, and decreased libido.

This content is part of Clínica Revitalize's commitment to translating science into accessible clinical practice — without losing rigor or depth.