Sanitation: Obesity drugs may improve low testosterone

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Health Rounds

By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we highlight three studies presented at a large annual meeting of hormone-disorder researchers. Two of the studies focused on GLP-1 drugs for obesity and diabetes - one suggesting the drugs can improve low testosterone in men, and another showing that even interrupted access to these expensive medications achieves significant weight loss. We also share findings that could be helpful for elderly patients with broken bones.

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Study Rounds

GLP-1 drugs may improve low testosterone in men

GLP-1 anti-obesity medications are linked with improvements in testosterone levels and health outcomes for men with obesity or type 2 diabetes, researchers reported in San Francisco at ENDO 2025, the Endocrine Society's annual meeting.

Weight loss from lifestyle changes or bariatric surgery is known to boost testosterone levels, but the impact of anti-obesity medications has not been widely investigated, study leader Dr. Shellsea Portillo Canales of SSM Health St. Louis University Hospital in Missouri said in a statement.

Portillo Canales and colleagues tracked 110 men with obesity – many also with type 2 diabetes – who were being treated with semaglutide, dulaglutide or tirzepatide, the active ingredients in Novo Nordisk's Wegovy and Ozempic or Eli Lilly's Trulicity, Mounjaro, and Zepbound.

The average age was 54. None of the men were receiving other testosterone-boosting medications.

During 18 months of treatment, the proportion of men with testosterone levels in the normal range rose from 53% to 77%.

Testosterone plays a critical role in male sexual functioning but can also impact bone mass, fat distribution, muscle mass, strength and red blood cell production.

In the current study, the greater the weight loss, the greater the improvement in testosterone levels, the researchers found.

While the study cannot prove GLP-1 drugs caused low testosterone levels to normalize, it does show a direct correlation, Portillo Canales noted.

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Intermittent access to GLP-1 drugs still yields weight loss

Popular GLP-1 anti-obesity medications are effective for weight loss even when treatment is inconsistent, new findings suggest.

Patients often face challenges in accessing these medications – such as Novo Nordisk's Wegovy and Ozempic and Eli Lilly's Zepbound and Mounjaro - due to supply shortages and insurance coverage obstacles, study leader Kaelen Medeiros of privately held weight-loss company Calibrate in New York said in a statement.

Medeiros and colleagues looked at how interruptions to GLP-1 medication access over the course of two years impacted weight-loss outcomes in 6,392 clients of Calibrate's online metabolic health program. Along with the drugs, the program also included intensive lifestyle interventions and coaching on diet, exercise, sleep and emotional health.

Overall, 72.5% of participants experienced at least one disruption in their GLP-1 treatment and 11.1% had multiple disruptions, Medeiros reported at ENDO 2025.

Participants who faced access issues reported a 13.7% weight loss within 12 months and a 14.9% loss within 24 months, on average. Those without treatment interruptions reported a 17% weight loss in 12 months and 20.1% in 24 months, on average.

Even those who received no more than four treatments over 12 months also achieved clinically significant weight loss, with more than 10% change in body weight on average.

"While unpredictable GLP-1 medication access is frustrating, the good news is that our research shows effective weight loss can still be achieved if paired with appropriate lifestyle changes and coaching support," Medeiros said.

Osteoporosis drugs can benefit high-risk elderly

People who experience a fracture after age 80 might benefit from medications to treat bone deterioration or weakness caused by osteoporosis, researchers reported at the Endocrine Society meeting in San Francisco.

Whether to start osteoporosis drugs at that age has been debated for fear that very elderly patients could be more susceptible to the side effects.

Researchers at the Cleveland Clinic reviewed medical records on 88,676 patients aged 80 and older who had suffered a fracture due to osteoporosis. Half of them had subsequently been treated with either Merck & Co.'s Fosamax, Roche and GlaxoSmithKline's Boniva, Amgen's Prolia, or Eli Lilly's Evista or Forteo.

The others did not receive any osteoporosis drugs.

Over the next five years, after accounting for patients' other health conditions, the hospitalization rate was 19% lower and the mortality rate was 15% lower in the group treated with bone-strengthening medications.

"The results of our study support the need to enhance the individualized initiation of treatment of osteoporosis, even in people who are older than 80," study leader Dr. Gianina Flocco said in a statement.

"Treating people to reduce the burden of osteoporosis complications, like fractures leading to disability or death, would play a significant role in improving health span in the growing older population."

This newsletter was edited by Aurora Ellis; additional reporting by Shawana Alleyne-Morris.

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