Abstract
<jats:p>Background: Obesity is a primary driver of functional male hypogonadism, including male obesity-associated secondary hypogonadism (MOSH), for which weight loss remains the first-line intervention. However, the behavioral determinants of eating behavior in this population remain poorly characterized. This exploratory analysis examined whether lower total testosterone (TT) levels were associated with specific domains of the Eating Behavior Phenotype Scale (EFCA). Methods: A cross-sectional analysis was conducted using baseline data from a retrospective outpatient cohort of men with obesity who had available total testosterone measurements. Eating behavior was assessed using the validated 16-item EFCA. Associations were assessed primarily using Spearman’s rank correlation, with Kendall’s tau and leave-one-out analyses performed as sensitivity analyses. Results: Of the analytical sample (n = 10; mean BMI 38.8 kg/m² among the nine participants with available anthropometry), eight participants completed the EFCA. Total testosterone (TT) levels (mean 310.7 ng/dL) did not correlate with the hedonic, compulsive, hyperphagic, or emotional domains. A strong inverse correlation was observed between TT and the disorganized domain (Spearman’s rho = −0.914; p = 0.0015). This association remained significant after Bonferroni correction and was confirmed by Kendall’s tau and leave-one-out sensitivity analyses. Conclusions: Lower TT levels were selectively associated with increased eating disorganization. These hypothesis-generating findings warrant confirmation in prospective studies incorporating comprehensive androgen profiling, including measurements of free testosterone and sex hormone-binding globulin (SHBG).</jats:p>