Relationship between Sexual Function and Quality of Life in Obese Persons Seeking Weight Reduction

Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
Obesity (Impact Factor: 3.73). 10/2013; 21(10). DOI: 10.1002/oby.20398
Source: PubMed


This study investigated sexual functioning in persons with obesity and seeking weight loss, and the associations of sexual functioning with relevant demographic and clinical variables as well as quality of life.

Design and Methods
Participants were enrolled in a two-year randomized clinical trial. Participants were obese and had at least two components of metabolic syndrome. Male and female sexual functioning was assessed by the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) respectively.

The rate of female sexual dysfunction was 29%. The rate of erectile dysfunction (ED) was 45%. Of the characteristics considered, FSD was associated with age (p=0.002). ED was significantly associated with age and physical functioning (both p <0.01).

A large minority of patients with obesity reported sexual dysfunction. The occurrence of sexual dysfunction was associated with age, but, surprisingly, not weight-related comorbidities. This may be the result of the nature of the study sample or the methods used to administer the questionnaires that assessed sexual functioning.

Download full-text


Available from: Reneé H Moore, Jul 28, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Many individuals with obesity are motivated to lose weight to improve weight-related co-morbidities or psychosocial functioning, including sexual functioning. Few studies have documented rates of sexual dysfunction in persons with obesity. This study investigated sexual functioning, sex hormones, and relevant psychosocial constructs in individuals with obesity who sought surgical and nonsurgical weight loss. One hundred forty-one bariatric surgery patients (median BMI [25th percentile, 75th percentile] 44.6 [41.4, 50.1]) and 109 individuals (BMI = 40.0 [38.0, 44.0]) who sought nonsurgical weight loss participated. Sexual functioning was assessed by the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Hormones were assessed by blood assay. Quality of life, body image, depressive symptoms, and marital adjustment were assessed by validated questionnaires. Fifty-one percent of women presenting for bariatric surgery reported a sexual dysfunction; 36% of men presenting for bariatric surgery reported erectile dysfunction (ED). This is in contrast to 41% of women who sought nonsurgical weight loss and reported a sexual dysfunction and 20% of men who sought nonsurgical weight loss and reported ED. These differences were not statistically significant. Sexual dysfunction was strongly associated with psychosocial distress in women; these relationships were less strong and less consistent among men. Sexual dysfunction was unrelated to sex hormones, except for sex hormone binding globulin (SHGB) in women. Women and men who present for bariatric surgery, compared with individuals who sought nonsurgical weight loss, were not significantly more likely to experience a sexual dysfunction. There were few differences in reproductive hormones and psychosocial constructs between candidates for bariatric surgery and individuals interested in nonsurgical weight loss.
    Surgery for Obesity and Related Diseases 07/2013; 9(6). DOI:10.1016/j.soard.2013.07.003 · 4.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: IMPORTANCE Obesity has been associated with impairments in sexual function and untoward changes in reproductive hormones in women. Relatively few studies have investigated changes in these domains following bariatric surgery. OBJECTIVE To investigate changes in sexual functioning, sex hormone levels, and relevant psychosocial constructs in women who underwent bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of 106 women from phase 2 of the Longitudinal Assessment of Bariatric Surgery who underwent bariatric surgery (median [interquartile range] body mass index, 44.5 [41.4-49.7]). Assessments were completed between 2006 and 2012. INTERVENTIONS Bariatric surgery was performed by a surgeon certified by the Longitudinal Assessment of Bariatric Surgery (85 women underwent a Roux-en-Y gastric bypass, and 21 women underwent laparoscopic adjustable gastric banding). MAIN OUTCOMES AND MEASURES Sexual functioning was assessed by use of the Female Sexual Function Index. Hormones were assessed by use of a blood assay. Quality of life, body image, depressive symptoms, and marital adjustment were assessed by use of validated questionnaires. RESULTS Women lost a mean 32.7% (95% CI, 30.7%-34.7%) of initial body weight at postoperative year 1 and a mean 33.5% (95% CI, 31.5%-35.6%) at postoperative year 2. Two years following surgery, women reported significant improvements in overall sexual functioning and specific domains of sexual functioning: arousal, lubrication, desires, and satisfaction. They also experienced significant changes at 2 years in all hormones of interest. Women reported significant improvements in most domains of quality of life, as well as body image and depressive symptoms, within the first year after surgery, with these improvements being maintained through the second postoperative year. CONCLUSIONS AND RELEVANCE Women who underwent bariatric surgery had significant improvements in overall sexual functioning, in most reproductive hormones of interest, and in psychosocial status. Improvements in sexual health can be added to the list of health benefits associated with bariatric surgery. TRIAL REGISTRATION Identifier: NCT00670098.
    JAMA SURGERY 11/2013; 149(1). DOI:10.1001/jamasurg.2013.5022 · 3.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The increased prevalence of obesity represents, currently, one of the major public health issues, due to its consequences on physical and psychological health status as well as on the psychosocial functioning. As defined by the World Health Organization, sexual health is "a state of physical, emotional, mental, and social well-being in relation to sexuality." The aim of the present study was to explore the relationship between sexual life in obese subjects and quality of life, psychological status, and disability. Methods. 95 obese subjects were recruited from June 2012 to February 2013 and underwent physical examination and measures for the assessment of quality of life, sexual life, psychological status, and disability. Results. In obese subjects sexual life was related to gender, age, psychological status, disability, and quality of life. Conclusion. As obesity is a multifactorial disease, and is accompanied by multiple comorbidities, it is difficult to identify a single causative factor responsible for the impairment of sexual life in obese subjects; thus, a thorough, multidimensional evaluation including sexual function assessment should be performed in obese people.
    International Journal of Endocrinology 02/2014; 2014:847871. DOI:10.1155/2014/847871 · 1.95 Impact Factor
Show more