Does Biote Help With Weight Loss? What the Evidence Shows

Does Biote help with weight loss?

It is one of the most common questions about Biote, and Biote reviews about weight loss go both ways. Some people say they slimmed down after starting pellets; others report bloating or gaining a few pounds. The research gives a clearer answer than the reviews: hormone therapy, including pellets, is not a weight-loss treatment, and no hormone product is approved for weight loss.

The question comes up partly because weight gain, especially around the middle, is so common in midlife. Biote’s own testosterone pellet page lists weight gain, “especially in the belly area,” among the symptoms of low testosterone, alongside fatigue, muscle weakness and low sex drive. What matters for you is what controlled trials show when women are actually given estrogen or testosterone.

Why does weight shift during menopause?

Menopause changes where weight goes more than how much you weigh. In the SWAN study, which followed women through the transition with body scans, the rate of fat gain doubled and lean mass began to fall as menopause started, while total weight kept rising at the same steady pace it had before (Greendale 2019). Those changes leveled off about two years after the final period.

The location changes too. In a four-year study, only women who became postmenopausal had a significant increase in visceral fat, the deep fat around the organs, and their energy use during sleep and fat burning both fell (Lovejoy 2008). The Menopause Society puts average midlife weight gain at about 1.5 pounds a year, with a shift toward central fat after menopause (Menopause Society 2022). Our guide to menopause weight gain covers the causes in more detail.

By the numbers

How weight shifts in midlife

2×faster rate of fat gain as menopause startsSource: Greendale 2019

~1.5 lbaverage midlife weight gain a yearSource: Menopause Society 2022

What does research say about estrogen therapy and weight?

Biote’s estrogen pellets contain estradiol, and estrogen’s effect on weight has been studied in many randomized trials.

• No change in weight. A Cochrane review of 22 trials found no significant difference in weight gain between women on estrogen alone or estrogen plus progestogen and women not on hormones. In other words, HRT did not cause extra weight gain, and it didn’t cause weight loss either.
• A small shift away from the belly. In a Women’s Health Initiative substudy of 835 women, three years of estrogen plus progestin meant less loss of lean tissue and a lower ratio of trunk to leg fat than placebo. The authors noted the effects were small. A 2006 meta-analysis of 107 trials found hormone therapy reduced abdominal fat by about 7% on average.
• The overall verdict. The Menopause Society notes that in the main WHI trials, women on hormone therapy had a smaller increase in waist circumference over the first three years than women on placebo. It concludes that hormone therapy may help limit belly fat build-up and weight gain during the menopause transition, but that the effect is small. It also notes that more physical activity was independently linked to less weight gain.

By the numbers

Estrogen therapy and weight in trials

22trials found no significant difference in weight gain on HRTSource: Norman 2000

~7%average reduction in abdominal fat on hormone therapySource: Salpeter 2006

That evidence comes mostly from FDA-approved pills and patches. There are no randomized trials showing that estradiol pellets do better for weight.

Do testosterone pellets change body composition?

Testosterone builds muscle in men, so it is easy to assume the same in women at female doses. Trials don’t support that.

• A meta-analysis of 36 randomized trials in women found no effect of testosterone on body composition or muscle, though data were limited, and it recorded a small overall weight increase in women taking testosterone.
• In a dose-finding trial of 71 postmenopausal women, lean body mass rose significantly only in the highest-dose group, whose average testosterone level was about 210 ng/dL, well above the normal female range. Lower doses did not differ from placebo.
• The global consensus statement on testosterone for women found its only evidence-based use is low sexual desire causing distress after menopause, called for more research on body composition and muscle, and advised against any preparation, including pellets, that produces above-normal levels.

Pellets often do produce above-normal levels. In a records study, average peak testosterone was about 194 ng/dL in women on pellets, compared with about 16 ng/dL in women on FDA-approved hormone therapy, and side effects were more common with pellets. So any muscle effect would come at levels that guidelines advise against, with the acne, hair growth and voice changes that can come with them. Our article on whether Biote is safe looks at those risks in more detail.

How should you read Biote weight loss reviews?

When someone loses weight after starting pellets, several things usually changed at once: they started a new plan, felt motivated, slept better as night sweats eased, or began exercising because they had more energy. Those are real benefits, but they are indirect. Going the other way, fluid retention in the first weeks after an insertion can show up on the scale as gain. Our roundup of what Biote reviews commonly report covers this pattern.

What actually helps with menopausal weight gain?

The tools with the best evidence don’t require a procedure:

• Exercise that combines cardio and strength. A meta-analysis of 101 trials in 5,697 postmenopausal women found exercise reduced fat mass, waist size and visceral fat and increased muscle. Aerobic and combined training did most for fat, while resistance and combined training did most for muscle. Our guide to the best exercise for menopause belly fat includes a sample weekly plan.
• Enough protein. Protein helps protect muscle as you lose fat. An expert group recommends 1.0 to 1.2 g per kilogram of body weight a day for adults over 65 (PROT-AGE). See protein and menopause.
• Protect your sleep. In a controlled study of people on a calorie-reduced diet, cutting sleep to 5.5 hours reduced the share of weight lost as fat by 55% and increased muscle loss (Nedeltcheva 2010).
• A sustainable eating pattern. Our menopause belly fat diet guide covers what to eat and limit.
• Medical help when needed. If weight is affecting your health, ask a clinician about FDA-approved weight-management medicines and other options.

Where does hormone therapy fit?

Amie HRT+ is one prescription option: a single compounded cream with estradiol and progesterone, at a strength a licensed clinician chooses after an online review. Like Biote pellets, it is compounded and not FDA-approved, and it is not a weight-loss treatment. Unlike a pellet, it is used at home and the strength can be changed at the next prescription. A clinician decides whether it is appropriate for you.