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The men were randomised to Weight Watchers weight loss programme plus placebo versus the same weight loss programme plus testosteronegel at a mean duration of 30 weeks (range = 9 months to 7 years). The aim was to assess the effect of the Weight Watchers weight loss programme on a range of metabolic, endocrine, neuroendocrine and psychological functions in men. Main Outcome Measures Metabolomic data were investigated and clinical tests included a battery of tests for plasma testosterone, free androgen index, sex hormone binding globulin, insulin receptor substrate 3a (insulin-like growth factor 3). Results Twenty-two men completed the study. Weight loss with both testosterone gel and Weight Watchers programme resulted in an estimated loss of 20.5 kg (P = 0.008 versus placebo), without changes to the mean baseline value (P = 0.826). Mean changes in fasting plasma testosterone and insulin were similar in groups (P = 0.611, P = 0.923 and P = 0.693, respectively). Significant decreases in fasting insulin and free testosterone and decreases of 9.8% and 12.9% at each time point were observed when compared with the placebo group. There were no significant changes in glucose, glucose-6-phosphate dehydrogenase, C-peptide, serum cortisol or cortisol-to-growth hormone ratio between groups within the first 4 weeks of treatment. Plasma leptin levels were lower in both groups. Conclusions In men with a male pattern of obesity, weight loss achieved with both a Weight Watchers diet and testosterone gel was associated with lower levels of body fat and improved glucose and insulin tolerance, although effects were attenuated at the end of treatment. These preliminary results support the efficacy of both weight loss programmes in this population and may have implications for future clinical trials. Treating obesity has increased global mortality in recent decades1,2. Weight loss on the Weight Watchers diet is currently the only current treatment regimen suitable for this population. However, the effect of dieting on health outcomes in obese men, and their subsequent treatment of weight regain, remains uncertain. This meta-analysis of 14 studies included 1184 participants. The weight loss programme resulted in decreased fasting plasma testosterone (P = 0.017), reductions in free testosterone (P = 0.015), no significant change in insulin, free T 3 (P = 0.749), and no changes in serum insulin-like growth factor 2 (SGLT-2). There were changes in fasting insulin, free androgen index, SGLT-2, glucose levels and plasma Similar articles: