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Obesity is a risk factor for multiple health problems, but its association with androgenetic alopecia (AGA) remains controversial.

We sought to determine the association between body mass index (BMI) and alopecia severity in men with AGA and early-onset AGA.

A cross-sectional study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed.

In all, 189 men were enrolled with a mean age of 30.8 years. In male-pattern AGA (n = 142), men with severe alopecia (grade V-VII) had higher BMI than those with mild to moderate alopecia (grade I-IV) (25.1 vs 22.8 kg/m², P = .01). After multivariate adjustments, the risk for severe alopecia was higher in the overweight or obese (BMI ≥24 kg/m²) subjects with male-pattern AGA (odds ratio 3.52, P < .01). In early-onset male-pattern AGA (n = 46), the risk for having severe alopecia was also …