Effect of Incretin-Based Weight Loss Drugs on Testosterone Concentrations in Men
Authors' conclusion
Incretin-based therapies were associated with increases in total and free testosterone, with the largest gains seen in those with greatest weight loss. These findings support a role for incretins in reversing obesity-related low testosterone, potentially reducing the need for exogenous testosterone therapy.
Study context
- Population
- Men aged 18 to 89 years, 2021–2024, with total testosterone measured before and during incretin therapy; men receiving androgen-related therapies excluded; mean age 55 ± 11 years, BMI 36.3 ± 7.1 kg/m², 77% T2D61 with paired free testosterone
- Participants
- 215 men
- Exposure
- Testosterone before vs during incretin therapy
- Outcome
- Changes in total and free testosterone
Methodological detailsbefore–after (pre/during incretin therapy), electronic health records, Data extracted from electronic health records
- Before–after (pre/during incretin therapy)
- Electronic health records
- Data extracted from electronic health records
Main finding
As reported in the abstract
Total testosterone
P < 0.001
Observational data: associations, not effects.
Further findings
Free testosterone · before vs during incretin therapy
- Free testosterone increased from 6.9 ± 3.0 to 8.0 ± 4.2 ng/dL
- P = 0.006
- 61 with paired measurements
Weight and HbA1c
- Weight loss with incretin therapy
- 5%
- Change in HbA1c
- −0.7 ± 1.6%, P < .001
Correlation of weight change with testosterone change
- Weight change vs total testosterone change
- r = −0.28, P < .001
- Weight change vs free testosterone change
- r = −0.26, P = .04
Patients with normal total testosterone · during incretin therapy
- Percentage with normal total testosterone increased from 67% to 86%
- P < 0.001
Original publication
Effect of Incretin-Based Weight Loss Drugs on Testosterone Concentrations in Men. Endocr Pract. Published 14 January 2026. doi:10.
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