engleski

Transgender fat turning obese men into hormonal women: study of gender-related changes in body composition during weight loss program

Introduction Healthy men tend to have more muscle and less fat mass than women due to higher levels of testosterone. Active endocrine adipose tissue in obese males contributes to the circulating pool of estrogens which results in distribution of adipose tissue and higher fat percentage. Obese men have frequently obesity related hypogonadsim and lower basal metabolic rate. The aim of this investigation was to explore changes in body composition in obese men and women during the same body weight reduction program. Methods Data from 161 obese patients (40 men, 121 women), mean age 50 years (22-80), attending structural weight loss program were analysed. A 5-day program included daily consultations with a multidisciplinary healthcare team. At the baseline and after 6 months anthropometric values (height, weight, body mass index -BMI) as well as body composition (fat mass, muscle mass) were estimated. Basal testosterone level was estimated in males. Results Baseline mean values of body mass, BMI, fat mass and muscle mass were 125 kg (78-240), 44 kg/m² (30-82), 58 kg (25-120) and 63 kg (43-139) retrospectively. In follow up after 6 months mean values of body mass, BMI, fat mass and muscle mass were 118 kg (72-223), 41 kg/m² (27-82), 52 kg (17- 104) and 62 kg (43-129) retrospectively. Basal testosterone level was 8.5 nmol/l (7.6-16). T- test of paired samples showed significant decrease in body mass (p<0.001), BMI (p<0, 001) and body fat mass after 6 months (p<0.001), but there was no significant difference in muscle mass (p=0.003). Patients were divided into two groups according to gender. In females mean weight loss was 6 kg (4.52%) and in males it was 15 kg (8.18%). Although both genders lost weight significantly, two different patterns were observed. In females there was significant decrease in body fat mass 8.93% with slightly decrease of body muscle mass 4%. In males there was significant decrease in both body fat mass 17.69% and body muscle mass 7.37%. Conclusion BMI and the percentage of weight loss do not provide real insight of the body mass changes. In our study, following the same weight loss program men lose weight more quickly than women. Interestingly, they had significant decrease of body muscle mass, even more pronounced than women. This phenomenon could be partly influenced by basal testosterone levels within the hypogonadal range causing even during weight loss sarcopenia in obesity. Approach to the obese male should take into consideration less testosterone and more estrogens than in those with normal weight. Since lifestyle measures usually modestly increase circulating testosterone, future plan is to increase exercise training program for males which will increase muscle mass.

obesity ; body composition ; testosterone ; weight loss

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