When most men think about low testosterone (hypogonadism), they think about symptoms like low libido, fatigue, or difficulty building muscle.
But what many don’t realize is that low testosterone can quietly change your body composition long before obvious symptoms appear.
Research shows that men with low testosterone tend to lose lean muscle mass, gain body fat, especially dangerous visceral fat around the organs, and experience declines in strength, metabolic health, and even bone density. These changes can increase the risk of obesity, frailty, diabetes, and cardiovascular disease.
Why Testosterone Matters for Body Composition
Testosterone plays a critical role in helping men:
- Build and maintain muscle mass
- Support healthy metabolism
- Limit fat accumulation
- Preserve bone strength
- Maintain physical performance
When testosterone levels fall, the body shifts in the opposite direction. Studies have found that men with hypogonadism often experience a reduction in lean body mass and an increase in body fat, particularly visceral fat stored deep in the abdomen. This type of fat is strongly associated with insulin resistance, inflammation, and heart disease risk.
The Problem With the Scale
A standard scale can’t tell you what kind of weight you’re gaining or losing.
You could weigh the same as you did five years ago while carrying significantly more body fat and less muscle. This is why many men feel weaker, slower, or less energetic despite seeing little change in their overall weight.
Understanding your body composition is often more valuable than simply tracking pounds on a scale.
How a DEXA Scan Measures What Matters
A DEXA (Dual-Energy X-ray Absorptiometry) scan is considered one of the most accurate tools available for evaluating body composition. It can precisely measure:
- Lean muscle mass
- Total body fat percentage
- Visceral fat levels
- Bone mineral density
- Regional fat distribution throughout the body
Unlike BMI, which only looks at height and weight, a DEXA scan provides a complete picture of what’s happening beneath the surface. The scan is quick, non-invasive, and exposes patients to very minimal radiation.
What Men With Low Testosterone Often Discover
Many men are surprised by what their DEXA results reveal.
Even active men may discover:
- Higher than expected visceral fat
- Loss of muscle mass despite regular exercise
- Early bone density changes
- Body composition patterns associated with metabolic disease
These findings can help explain symptoms that blood work alone doesn’t fully capture.
Can Testosterone Replacement Therapy Improve Body Composition?
Evidence suggests that testosterone replacement therapy (TRT) can help improve body composition in appropriately selected men with testosterone deficiency.
Clinical studies have shown that TRT may:
- Increase lean muscle mass
- Reduce body fat
- Lower waist circumference
- Improve physical function and strength
The greatest improvements are often seen in men with more significant testosterone deficiency. However, successful treatment should always be paired with proper nutrition, exercise, sleep, and ongoing monitoring.
Take a Data Driven Approach to Men’s Health
If you’re struggling with symptoms of low testosterone, unexplained weight gain, declining strength, or difficulty building muscle, understanding your body composition can provide valuable insights.
At Maze Men’s Health, we take a comprehensive approach to men’s wellness. Through our branch Maze Medical Fitness Testing, we offer advanced DEXA scans that measure body fat, muscle mass, visceral fat, and bone health, giving you a clearer picture of your overall health and helping guide personalized treatment decisions.
Whether you’re considering TRT, optimizing your fitness goals, or simply want to understand how your body is changing with age, a DEXA scan can provide the objective data you need to take action.
Learn more about Maze Medical Fitness Testing and schedule your DEXA scan today.
Sources:
Delbarba A, et al. Body Composition in Male Hypogonadism: Practical Considerations to the Use of Dual-Energy X-Ray Absorptiometry. Reviews in Endocrine and Metabolic Disorders. 2026.
