Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study.

Department of Endocrinology, University College London Hospital Medical School, London, UK.
European Journal of Endocrinology (Impact Factor: 3.14). 04/2011; 164(6):1003-11. DOI: 10.1530/EJE-10-1129
Source: PubMed

ABSTRACT Few published data link overweight and obesity with measures of quality of life (QoL) including sexual health in men.
To assess the association of overweight/obesity with impairment of physical and psychological QoL and sexual functions in men.
Cross-sectional, multicentre survey of 3369 community-dwelling men aged 40-79 (mean±s.d., 60±11) years randomly selected from eight European centres.
Adiposity was assessed by body mass index (BMI) and waist circumference (WC), QoL and functional impairments by physical and psychological function domains of the Short Form-36 questionnaire, Beck's Depression Inventory and the European Male Ageing Study sexual function questionnaire.
Complete data on sexual activities and erectile function were available in 2734 (92%) and 3193 (95%) of the participants respectively. From the population studied, 814 men were obese (BMI ≥30 kg/m(2)) and 1171 had WC ≥102 cm, 25% of all men were unable to do vigorous activity and 2-13% reported depressive symptoms. Symptoms of sexual dysfunction ranged between 22% (low sexual desire) and 40% (infrequent morning erections) of the participants. Among obese men with both BMI ≥30 kg/m(2) and WC ≥102 cm, at least one symptom of impaired physical, psychological and sexual function was reported by 41, 43 and 73% of the participants respectively. Compared with the reference group of non-obese men (BMI <30 kg/m(2) and WC <102 cm), men with BMI ≥30 kg/m(2) and WC ≥102 cm more frequently reported at least one symptom of impaired physical function (odds ratio (OR)=2.67; confidence interval (CI): 2.07-3.45, P<0.001), impaired psychological function (OR=1.48; CI: 1.14-1.90, P<0.01) and impaired sexual function (OR=1.45; CI: 1.14-1.85, P<0.01). These functional impairments were also more prevalent in men who had WC ≥102 cm even with BMI <30 kg/m(2), but those with BMI ≥30 kg/m(2) and WC <102 cm generally did not suffer from increased impaired physical or sexual health. Men with high BMI and WC were at even greater likelihood of having a composite of two or more or three or more symptoms compared with those with normal BMI and WC.
Men with high WC, including those who are 'non-obese' with BMI <30 kg/m(2), have poor QoL with symptoms of impaired physical, psychological and sexual functions. Health promotion to improve QoL should focus on prevention of obesity and central fat accumulation.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Sexual dysfunction is more prevalent in obese than in normal-weight men. Meal replacements (MRs) are useful weight-loss strategies. We randomized obese (body mass index27.5 kg m(-2), waist circumference (WC)90 cm) Asian men (mean age 40.5 years, range 30-61) to a conventional reduced-fat diet (CD) (n=24) or MR-based plan (n=24) to reduce daily intake by 400 kcal for 12 weeks. There were significantly greater reductions in weight (4.2±0.8 kg), WC (4.6±0.7 cm), calorie and fat intake in the MR group, compared with the CD group (2.5±0.4 kg, 2.6±0.5 cm). Erectile function (International Index of Erectile Function 5-item score) improved comparably in the MR (3.4±0.7 points) and CD (2.5±0.5 points) groups, as did the Sexual Desire Inventory score (5.5±2.3 vs 7.7±2.1 points), quality of life (36-item Short Form survey score), plasma testosterone and endothelial function (Reactive Hyperemia Index). Subjects were switched to or continued CD for another 28 weeks. Weight, WC and erectile function were maintained at 40 weeks. MR induces greater reductions in weight and abdominal obesity than conventional diet, and comparable improvements in sexual and endothelial function, testosterone and quality of life.International Journal of Impotence Research advance online publication, 7 November 2013; doi:10.1038/ijir.2013.36.
    International journal of impotence research 11/2013; · 2.73 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 01/2014; 2014:847871. · 2.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was aimed to identify characteristics of ED patients who discontinued PDE5i despite successful intercourse. Data were collected using a questionnaire from 34 urologic clinics regardless of the effect (success or failure) of PDE5i treatment by visiting the clinics (717), e-mail (64) or post (101) for 882 ED patients who had previously taken any kind of PDE5i on demand four or more times. Discontinuation of PDE5i was defined if the patient had never taken PDE5i for the previous 1 year despite successful intercourse. Of the 882 patients, 485 were included in the final analysis. Difference in the socio-demographic, ED- and partner-related data between the continuation and discontinuation group and factors influencing discontinuation of the PDE5i were analyzed. Among 485 respondents (mean age, 53.6), 116 (23.9%) had discontinued PDE5i use despite successful intercourse. Most common reasons for the discontinuation were 'reluctant medication-dependent intercourse' (31.0%), 'spontaneous recovery of erectile function without further treatment' (30.2%), and 'high cost' (26.7%). In multiple logistic regression analysis, independent factors influencing discontinuation of the drug were cause of ED (psychogenic), short duration of ED, low education ( middle school), and religion (Catholic). In partner-related compliance, only partner's religion (Catholic) was a significant factor.International Journal of Impotence Research advance online publication, 5 December 2013; doi:10.1038/ijir.2013.41.
    International journal of impotence research 12/2013; · 2.73 Impact Factor

Full-text (2 Sources)

Available from
May 19, 2014