Ashley Clift

Conflicts of Interest A.C.B.-F., J.C.T.C., and G.G. are employed by MANUAL LTDA, and D.R., A.K.C., H.J., and D.R.H. are employed by Menwell Limited, the sponsoring company for this study. Data Availability Statement The datasets generated and/or analyzed during the current study are not publicly available due to legal and privacy constraints, as they are derived from a private digital healthcare platform.

1 Introduction Testosterone deficiency (TD), also referred to as hypogonadism, is a condition characterised by low testosterone levels and associated symptoms such as reduced libido, erectile dysfunction and decreased energy, which may impair physical, emotional and social functioning [1]. In addition, low testosterone levels are associated with increased risks of diabetes, dementia, cardiovascular disease and mortality (2%–5%), severely compromising quality of life (QoL) and healthy longevity.

• , , , et al. Tirzepatide once weekly for the treatment of obesity . N Engl J Med. ; ( ): - . doi:10.1056/NEJMoa2206038 • , , . Mapping the effectiveness and risks of GLP-1 receptor agonists . Nat Med. ; ( ): - . doi:10.1038/s41591-024-03412-w • , , , et al. Semaglutide improves cardiometabolic risk factors in adults with overweight or obesity: STEP 1 and 4 exploratory analyses . Diabetes Obes Metab. ; ( ): - . doi:10.1111/dom.14890 • .