One of the most common misconceptions in healthcare is that obesity can always be cured by eating less and exercising more. While diet and exercise play a key role in maintaining a healthy body composition, obesity is not always so easily corrected. Once individuals reach a BMI above 30, traditional methods of weight loss can become less effective. This is largely due to a phenomena known as "genetic resetting", where fat cells and adipose tissue become dysfunctional. When fat cells become dysfunctional, various inappropriate signals are sent to the brain which interfere with it's ability to regulate metabolism, hunger, and satiety. In short, losing weight for an individual at this point no longer comes down to personal choice, but becomes a matter of biology. This is where weight loss medications can help make the difference.

As it pertains to testosterone levels - fat cells contain an enzyme called "Aromatase", which functions to convert Testosterone into Estradiol (Estrogen). This is why Low Testosterone is more common in obese individuals. An obese male with low testosterone could actually be producing plenty of it naturally, but won't be able to feel that because fat cells are quickly turning it into estrogen.

When it comes to TRT, individuals with higher BMI's due to excessive fat tissue should usually be taking an estrogen blocker simultaneously to ensure that treatment doesn't go to waste by being converted into estrogen. Weight loss must absolutely be a number one priority. TRT can help give you the motivation and energy needed to find your exercise rhythm and routine. Many obese individuals even find that they no longer need TRT once they obtain a healthier BMI, because their testosterone levels return to normal without having extra fat tissue converting all their naturally produced testosterone into estrogen.

There are a variety of different FDA approved weight loss medications, each with their own respective pros and cons. Please click the link below for a general overview.

Prescription weight-loss drugs: Can they help you? - Mayo Clinic