Weightloss: Men’s Health Challenges Related to Overweight and Obesity – Comorbidities and Complications

Weightloss: Men’s Health Challenges Related to Overweight and Obesity – Comorbidities and Complications

Today, a considerable percentage of adults live with overweight or obesity, ranking it among the most prevalent chronic diseases globally, with millions of men facing various physical, hormonal, and psychological challenges due to excess body weight [1] . Increasing knowledge about these challenges is an important foundation for living a longer, healthier life with an improved quality of life. This article explores the key factors contributing to weight gain in men, including hormonal imbalances, such as testosterone deficiency, the impact of ageing, and conditions like hypogonadism. In addition to the testes, the adrenal glands also contribute to testosterone production, playing a role in overall hormonal health. It also illuminates the challenges men face, and explores how to approach weight loss in a way that prioritizes hormonal health and overall wellbeing.

Obesity in Men

Beyond the numbers on a scale, overweight and obesity is associated with a range of health complications. Excess weight is associated with more health issues and can be more pronounced in men due to unique biological and hormonal factors. In addition, obesity also increases the risk of various types of cancer, fatty liver, sleep apnoea, sexual dysfunction, joint problems, and pain in hips, knees, back, and feet, as well as mental health issues. Other conditions often occurring alongside obesity include gallstones, certain neuropsychiatric conditions, infertility, and urinary incontinence. Certain medical conditions, as well as diseases and medications, can also contribute to weight gain or complicate obesity management in men by affecting weight management strategies and exercise recommendations. On top of this, societal norms often discourage men from seeking help, leading to delayed interventions. For many men, managing weight is complex, as it is not just about diet and exercise but also involves underlying hormonal and psychological aspects.

Visceral Fat and the Risks with Obesity

The effects of obesity extend far beyond surface-level concerns. With excess weight, men have a tendency of visceral fat accumulation, in the abdominal region, around internal organs, that poses unique health risks for men. Unlike subcutaneous fat, which lies just beneath the skin, visceral fat, and an increased waist circumference (waist measurement), are strongly linked to an increased risk of heart disease, type 2 diabetes, and other serious health problems. Even modest weight loss can lead to a significant reduction in visceral fat, resulting in improved health outcomes and a lower risk of complications. A well-structured weight loss program that emphasises these lifestyle changes can help men achieve and maintain a healthy body weight, reduce their risk of chronic disease, and support long-term health. Understanding the dangers of visceral fat can be a powerful motivator for making positive changes and prioritising health.

Hormonal Factors in Men’s Weight Regulation

Hormonal balance plays an important role in how men regulate their body weight, and most hormones have some kind of involvement in metabolism and weight regulation. While no single hormone is solely responsible for this process, several hormones interact to control hunger, satiety, metabolism, and body composition. Among these, the hormone testosterone is highly relevant for men’s health. Produced primarily in the testicles, it supports muscle growth, bone density, and influences fat distribution.

Healthy testosterone levels are associated with greater lean muscle mass and lower levels of visceral fat. Conversely, low testosterone — which is often seen in men with obesity — can contribute to increased fat accumulation, particularly around the abdomen, and may exacerbate risks of cardiovascular disease, high blood pressure, and type 2 diabetes. Low levels can also reduce energy, motivation, and make it more difficult to maintain muscle mass, indirectly influencing weight regulation

However, the central regulators of weight and appetite are other hormones and signals from the brain and gut, including leptin, ghrelin, insulin, and gut-derived peptides such as GLP-1 and GIP. These orchestrate hunger and satiety, and disturbances in their signaling play a key role in the development of obesity. 

Understanding how the hormone testosterone interacts with this broader hormonal network provides a more complete picture of men’s weight regulation. Weight loss management strategies based on regular physical activity, balanced nutrition, and sustainable lifestyle changes help improve hormonal balance overall health. In some cases, medical evaluation and treatment of underlying hormonal issues with the help of a health care professional may be necessary. By recognising the interplay of multiple hormones, men can take proactive steps to reduce body fat, lower their risk of chronic disease, and support long-term health.

Understanding the Risks of Obesity: A Comprehensive Overview

Addressing the risks of obesity involves understanding the wide-ranging health implications that excess weight can have on the body. These risks are interconnected, often compounding the overall health burden, particularly in men. Here, we explore the major health concerns associated with obesity, emphasising how excess visceral fat and hormonal imbalances contribute to a variety of serious conditions:

Cardiovascular Complications and  Metabolic Syndrome in Men
Excess weight and visceral fat can impair the body's ability to regulate blood pressure, blood sugar, and lipids, leading to a cluster of conditions known as metabolic syndrome. This syndrome involves interconnected risk factors that often occur together and exacerbate each other, including [8-9]:

• Abdominal Obesity
• High Blood Pressure
• Dyslipidemia (high triglycerides – low HDL)
• Insulin Resistance

Metabolic syndrome significantly increases the risk of cardiovascular disease — the leading cause of death [8-10]. Men tend to develop these conditions earlier and more aggressively, often resulting in higher morbidity [10]. 

Fatty Liver - Non-Alcoholic Fatty Liver Disease

‍While alcohol has long been recognised as a primary cause of serious liver disease, obesity-related fatty liver or hepatic steatosis (recently re-termed MASLD) has become increasingly prevalent, especially among men. MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), previously known as NAFLD (Non-Alcoholic Fatty Liver Disease), is associated with metabolic syndrome, especially insulin resistance, leading to increased lipolysis in adipose tissue and fat accumulation in the liver.  If left unmanaged, the health effects of these conditions include an increased risk for cardiovascular and liver diseases. [13].

Sarcopenic Obesity: A Hidden Risk in Older Men

‍In aging men, visceral fat accumulation coupled with muscle loss — termed sarcopenic obesity — poses a hidden danger. This combination leads to frailty, increased risk of falls, insulin resistance, and higher mortality rates  [24].

‍
Obesity and Cancer Risk

‍Obesity is not only a major risk factor for cardiovascular disease and diabetes, it is also linked to a higher risk of several cancers, including colorectal, liver, prostate, kidney, gallbladder, and pancreatic cancers. The World Health Organization (WHO) estimates that around 40% of all cancers could be prevented through healthier lifestyle choices such as improved diet, increased physical activity, smoking cessation, and reduced UV exposure. Chronic low-grade inflammation and altered insulin signaling, both common in obesity, as well as hormonal imbalances, including lower testosterone and higher estrogen, are all factors that may promote oncogenesis and may further contribute to cancer development. Maintaining a healthy weight can substantially reduce these risks and support long-term health [13].

Sleep Problems and Affected Energy Levels

‍Sleep apnea, characterised by brief pauses in breathing during sleep, disrupts rest and triggers sympathetic nervous system activation — raising heart rate, blood pressure, and adrenaline, while oxygen levels drop. These disturbances can cause daytime fatigue, worsen hypertension, and elevate stroke risk.

Hormonal Factors - Low Testosterone (Hypogonadism)

‍Testosterone plays a vital role in muscle building, fat distribution, and overall metabolism [15]. Many overweight and obese men experience low testosterone levels, which can cause reduced libido, erectile dysfunction, infertility, decreased muscle mass, osteoporosis, and increased cardiovascular risk (abdominal obesity, type 2 diabetes and hypertension). The hormonal imbalance results from increased aromatase activity in fat tissue, converting testosterone into estrogen, leading to elevated estrogen levels and the development of breast tissue (Gynecomastia). 

Low testosterone can also impair mood, cognitive function, and emotional wellbeing. For men with testosterone deficiency, hormone replacement therapy (TRT), combined with lifestyle modifications, can be beneficial. At Yazen, we offer personalised treatment plans, including the ADAM test, to identify deficiencies and restore hormonal balance effectively.

Find out more about ‘Why Testosterone Levels decrease with Obesity and how to Approach it’ (länk till testosterone artikel).

Psychological and Societal Factors

‍Obesity is closely linked with mental health issues, including anxiety, depression, and feelings of shame. Societal pressures around masculinity and body image can discourage men from seeking help, exacerbating the problem. Additionally, unhealthy behaviors like excessive alcohol consumption, eating disorders (binge eating disorder, BED), neuropsychiatric disorders and diagnoses (NPF), and antidepressant medications, can contribute to weight challenges. Addressing obesity requires a holistic approach emphasising mental wellbeing, social support, and removing stigma..

Pain and Digestive Issues

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Excess weight puts strain on weight-bearing joints such as knees and hips, leading to pain and inflammation. Weight reduction can alleviate joint stress, reducing osteoarthritis symptoms. Obesity also increases the risk of gastrointestinal problems, such as acid reflux and gallstones, which can be mitigated through diet, for ex. by limiting high in fat foods, and lifestyle modifications.

Vitamin D Deficiency

‍Low vitamin D levels are common in obese individuals, partly due to its fat-soluble nature being stored in adipose tissue, and partly due to reduced outdoor exposure and impaired liver function. Adequate vitamin D is essential for bone health, immune function, and psychological wellbeing.

This holistic understanding underscores the importance of comprehensive assessment and personalised treatment strategies to effectively manage obesity and its associated health risks in men.

Beyond BMI: More Tools for Assessing Obesity

While Body Mass Index (BMI) is a widely used tool for assessing weight status, it does not always provide a complete picture of an individual’s health risks. For men, especially those with higher muscle mass, BMI can sometimes be misleading, because BMI does not distinguish between muscle and fat mass, well-trained men may be misclassified as overweight, while men with low muscle mass and high visceral fat can appear normal weight despite elevated risk. Experts therefore nowadays recommend complementing BMI with waist circumference, waist-to-hip ratio, and body fat percentage [3], to better evaluate the risks associated with excess weight. These tools help identify individuals who may be at increased risk for health problems, even if their BMI falls within a “normal” range. By using a combination of measurements, health care professionals can develop more personalized weight loss strategies that address each person’s unique needs. This holistic approach not only supports healthy living but also enhances overall well-being by focusing on more than just the number on the scale.

Small Reduction, Big Impact

Often, a 5% weight reduction is enough to reduce health risks associated with obesity, and with a 10-15% weight reduction, the risk reduction is substantial. Making efforts to lose weight can significantly reduce health risks and improve overall well-being. For example, a man weighing 100 kg who loses 5% of his body weight (5 kg) may see improvements in blood pressure, cholesterol, and blood sugar levels. It is not necessary to become ‘normal weight’ to reduce the strain on the body and the risk of complications. In metabolic syndrome, the various risk factors are closely linked, and rather than treating high blood pressure, high cholesterol levels, and elevated blood sugar separately, it is often more effective to address the root cause – losing weight, eating better, and being more active, will influence several risk factors simultaneously. Building better health from a holistic perspective, combining medical treatment, lifestyle changes, and psychological support is required.

Management and Weight Loss Strategies for Men
- a multifaceted approach

Effective weight management in men requires a multifaceted approach, combining lifestyle modifications, medical interventions, and tailored support strategies. Involving family members in weight management and healthy eating habits can provide essential encouragement and help reinforce positive changes.

• Strength Training and Physical Activity: Regular resistance training helps preserve muscle mass, improve metabolism, and counteract age-related declines [21]. Men in particular benefit from structured strength programs, as they combat sarcopenic obesity — a hidden risk that combines muscle loss with fat gain in older men. Both resistance training and aerobic exercise can also increase metabolic rate, supporting weight loss by enhancing energy expenditure.
• Diet and Nutrition: A balanced diet rich in whole foods, fiber, and lean proteins helps control weight and reduce fat accumulation [22]. Men often face unique challenges such as higher fast-food intake and alcohol consumption, which contribute significantly to excess calories. Various diets, including low-fat diets, high-protein diets, and high-fiber diets, have been studied for their effectiveness in weight management, with each offering different benefits and considerations. Substituting higher-fat foods with certain foods, such as reduced-fat or nonfat options like skim milk, nonfat yogurt, and baked chips, can support weight loss and maintenance. Sustainable approaches — portion control (for eg. using Mealsizer®), healthier cooking methods, and nutrition education — are essential. Nutrition education and counseling can promote behavioral changes that support long-term weight management by addressing emotional and psychological factors influencing eating habits. Being mindful of what and how much you eat is crucial for controlling calorie intake. Monitoring total calories consumed is a key factor in achieving and maintaining weight loss. Adhering to healthy eating patterns over extended periods is important for sustained weight loss and maintenance. Strategies that support long term weight loss, such as ongoing behavioral and lifestyle modifications, are critical to prevent weight regain.
• Lifestyle Changes: Adequate sleep, stress management, and consistent physical activity all play vital roles in maintaining weight and hormonal balance [23]. Building routines that are practical and sustainable is especially important for men, who may be less likely than women to seek structured support. Adopting healthy ways to manage weight, such as nutritious cooking and creating supportive environments, can further enhance long-term success.
• Medical Interventions and GLP-1 Agonists Modern obesity medications, such as GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) have revolutionized obesity treatment by enhancing satiety, lowering appetite, and improving glucose control [25]. Evidence shows gender-specific differences: men may achieve greater reductions in visceral fat and cardiometabolic risks, while women often experience greater overall weight loss [26,27]. Recognizing these differences is essential when tailoring treatment plans.
• Surgical Options: For men with severe obesity who have not achieved significant weight loss through diet, exercise, and other weight loss strategies, bariatric surgery may be an option to consider. Procedures such as gastric bypass or sleeve gastrectomy work by reducing the size of the stomach or altering the digestive system, which limits food intake and nutrient absorption. While bariatric surgery can be a powerful tool for weight loss, it is typically reserved for those who have exhausted other options and is always performed under the guidance of experienced health care professionals. These procedures can lead to significant and sustained weight loss, but it’s important to understand that surgery is not a quick fix, but require careful evaluation, follow-up, and long-term lifestyle adaptation.

Men's challenges with Obesity

It is essential to discuss your options with a health care professional. Sustainable outcomes rely not only on clinical treatment but also on support systems — counseling, peer programs, and community-based resources — a holistic treatment that can help adhere to healthy behaviors and maintain weight loss. Making informed decisions with the guidance of your health care team ensures the best possible outcomes for your health and well-being. Yazen takes a comprehensive approach to physical and mental health, lifestyle habits, and risk factors. There is no simple universal solution that suits everyone. By addressing the individual's specific challenges regarding overweight and weight reduction with respectful treatment and person-centred care, we support you on the path to better health. 

In Conclusion: A Holistic Approach to Men’s Wellbeing

In a world often focused on generic solutions, it’s crucial to understand that the journey from obesity to wellness is multifaceted and uniquely personal that demands a specialised approach.  Addressing weight loss for men also requires the recognition of a treatment plan designed for physical and mental care. The hormonal shifts, body image, and personal goals need to be factored in for weight loss and general health. Even a modest weight loss can significantly benefit cardiovascular health, lower blood pressure, and improve other risk factors. Excess body fat can lead to serious organ damage and life-threatening complications and the increase in risk is more pronounced in men, who  also tend to develop complications earlier compared to women, underscoring the need for gender-specific approaches to obesity treatment [2]. Early detection, intervention and preventative measures are crucial for effective management and can lead to better outcomes for men’s health. It’s essential to recognize obesity as a medical chronic condition, requiring specialized attention, not a personal failing. 

At Yazen, we understand these complexities and tailor our approach to address all these components, providing personalized support that considers your individual needs and circumstances. Tackling weight challenges often requires a combination of lifestyle changes, medical interventions, and psychological support and an understanding of how the different components interrelate. It’s a commitment to reclaiming health and enhancing quality of life. Managing weight effectively can significantly reduce the risk of serious health conditions such as cardiovascular disease and diabetes.

Disclaimer: This article is intended for informational purposes only and does not constitute medical advice. Please consult with a healthcare professional for personalized recommendations.

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