According to statistics, since 2018, more people have started using testosterone replacement therapy (TRT), especially after the COVID-19 pandemic. Young people under 24 have seen a 120% rise in use, and those 65 and older are using it 12% more than before.
If you’re on testosterone therapy, you might expect more energy, muscle growth, or a faster metabolism. But sometimes, instead of weight loss or more muscle, you notice your body weight going up. This can be confusing or even frustrating. Let’s explore why weight gain can happen with testosterone treatment and what it really means for your body.
What Is Testosterone Therapy?
Testosterone replacement therapy, or TRT, is used to bring your testosterone levels back to normal. As you get older, or if you have low testosterone (also called low T) or a hormonal imbalance, your levels can drop.
With TRT, doctors can use patches, injections, gels, or tablets to help boost your testosterone to healthier levels. This treatment is most common for men, but some women may also use testosterone therapy if they have certain hormone problems or issues with sexual function.
Benefits of Testosterone Therapy
Testosterone replacement therapy offers several advantages if you have low testosterone levels or a hormonal imbalance. Here are some of the main benefits you might experience with testosterone therapy:
- More Energy: Testosterone therapy can help you feel less tired and boost your motivation throughout the day.
- Easier Muscle Growth: It supports muscle building, helps you gain lean muscle mass, and makes it easier to maintain muscle, especially as you age.
- Better Mood: Many people notice their mood improves, with less irritability and a brighter outlook, after starting testosterone replacement therapy.
- Improved Sexual Function: TRT can help with erectile dysfunction in men and also increase libido in both men and women.
- Stronger Bones: Healthy testosterone levels help support bone mass, lowering your risk of thinning bones and fractures.
- Healthier Body Composition: Testosterone therapy can reduce fat mass (especially stubborn belly fat) while increasing muscle, leading to a healthier body composition.
- Weight Management Support: With more muscle and a boosted metabolism, managing your weight or avoiding excess weight becomes easier.
How Does Testosterone Make You Gain Weight?
Some people are surprised to see the number on the scale go up after starting testosterone therapy. You might wonder if testosterone treatment is causing weight gain or if something else is happening.
Here are some common reasons this can occur:
Water Retention
When you begin testosterone replacement therapy, your body often holds onto extra water at first. This can make your body weight go up by a few pounds, but it isn’t the same as gaining fat mass. Often, this initial weight gain goes away as your body gets used to the new hormone levels.
Muscle Gain
Muscle building relies heavily on the role of testosterone. With healthy testosterone levels, your body is better at building lean muscle mass. Muscles weigh more than fat, so as you gain more muscle, especially if you start strength training or a new exercise routine, your weight can increase, even as your shape improves. This is a sign of healthier body composition, not just gaining excess weight.
Changes in Fat Distribution
Sometimes, testosterone replacement therapy can help you lose fat in certain areas, like belly fat, but gain muscle in others. This shift may show up as weight gain on the scale, but it means you’re burning fat and adding lean mass.
Appetite and Metabolism
Some people notice their appetite increases after starting testosterone, which may lead to eating more calories. If you eat more than your body uses, you may gain body fat. On the flip side, a boosted metabolism and more muscle can help you lose fat and manage weight if you keep your diet and exercise routine on track.
Other Health Issues
If you have insulin resistance, changes in insulin sensitivity, or other hormonal imbalances, these can also affect how your body gains or loses weight. Managing these conditions with your healthcare provider is important if you want to lose weight or avoid fat gain.
Note: It’s important to remember that not all weight gain from testosterone replacement therapy is a bad thing. Focus on how you feel and what your body can do, not just the number on the scale.
Lifestyle Factors Influencing Weight
Managing your weight during testosterone replacement therapy is about more than just taking your medicine. Your daily habits and activities can make a big difference in whether you gain weight, lose fat, or keep a steady body weight.
Diet and Exercise
Even if you’re on testosterone therapy, you will add weight if you consume more calories than your body burns. Not staying active or skipping strength training means less muscle gain and less fat loss. Adding lean proteins and regular exercise helps support muscle mass and a healthier body.
Lifestyle Habits
Poor sleep and high stress can raise your appetite and slow down fat loss. Drinking too much alcohol adds calories and can build up more body fat.
Other Health Conditions
Issues like obesity, metabolic syndrome, or a history of bariatric surgery can make it harder to lose fat or see big changes in body composition. These conditions can also affect your hormone levels and insulin resistance.
Medications and Supplements
Some medicines and supplements can interfere with testosterone or insulin, making it harder to manage weight.
Simple Ways to Improve Your Results on Testosterone Therapy
Making a few smart changes to your daily habits can make a big difference in how your body responds to testosterone replacement therapy. These steps can help you avoid unwanted weight gain, build more muscle, and support a healthier body composition:
Eat Lean Proteins and Whole Foods
Choose foods that help muscle growth and give your body the nutrients it needs. Good options are chicken, fish, eggs, beans, nuts, and plenty of vegetables. Limit processed snacks, fast food, and sugary drinks, which can add unwanted body fat.
Get Moving With Regular Exercise
Aim to fit both strength training and cardio into your week. Building lean muscle mass and burning fat becomes easier when you lift weights or use resistance bands. Activities like walking, swimming, or cycling support weight loss and benefit your heart.
Sleep Well and Manage Stress
Getting enough sleep supports healthy hormone levels, muscle recovery, and weight management. Poor sleep or high stress can raise your appetite and make it easier for belly fat to stick around. Take time to relax with activities like deep breathing, light stretching, or hobbies you enjoy.
Track Your Progress
Look beyond the number on the scale. Notice the fit of your clothes, the energy you have, and the strength you feel. Keeping an eye on your body fat, muscle mass, and waist size gives you a clearer picture of your body composition. Your body mass index (BMI) can be one tool, but it’s not the whole story—how you feel and function matters, too.
Get Help From a Professional
If you’re not sure where to start or feel stuck in your progress, talk to your healthcare provider. They can offer a personalized diet and exercise plan, check your hormone levels, and help you manage any issues like insulin resistance or trouble losing weight.
When to Call Your Doctor During Testosterone Therapy
While testosterone replacement therapy is usually safe when monitored closely, it’s important to know when something isn’t right. Here are times when you should reach out:
Sudden Weight Gain
If your body weight jumps by several pounds in just a week or two, this might be more than just muscle gain or water retention. Quick changes like this should be discussed right away.
Unexplained Swelling
Watch for swelling in your legs, ankles, hands, or face. If you notice fluid buildup in these areas or feel puffy in general, let your doctor know, as this could signal water retention or another problem.
Breathing or Heart Issues
If you have trouble catching your breath, feel chest pain, your heart is racing, or you’re more short of breath than usual, contact your healthcare provider immediately.
New Sexual Function or Mood Problems
If you experience new or worsening erectile dysfunction, changes in libido, or strong mood swings, share this with your provider. This could mean your hormone levels need adjusting.
Can’t Lose Weight Even With Effort
If you’re sticking to your exercise routine and a healthy diet but still can’t lose body fat or manage your weight, let your doctor know. They can check for issues like insulin resistance, hormonal imbalance, or changes in your metabolism that could affect weight loss.
Get the Support You Need for Testosterone Therapy at BioMed Health Center
If you are gaining weight or experiencing changes in your body while on testosterone therapy, you don’t have to figure it out by yourself. At BioMed Health Center in San Diego, CA, we help people just like you manage body weight, muscle mass, and fat loss during testosterone replacement therapy. Our reliable team listens to your concerns and creates a plan that fits your needs.
If you want help with weight management, healthy habits, or hormone balance, we are here for you. Book your consultation today, and let us work together toward your best health.