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: 4.07). 04/2011; 164(6):1003-11. DOI: 10.1530/EJE-10-1129
Source: PubMed


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.

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Available from: Margus Punab, Dec 26, 2013
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    • "Noninstitutionalized men aged 40–79 years were recruited from municipal or population registers in eight centers: Florence (Italy); Leuven (Belgium); Łódź (Poland); Malmö (Sweden); Manchester (UK); Santiago de Compostela (Spain); Szeged (Hungary) and Tartu (Estonia). In the European Male Ageing Study study, compared with the reference group of lean European individuals (BMI <30 kg m−2 and WC <102 cm), men with a BMI > 30 kg m−2 and/or WC >102 cm were, in fact, twice as likely to have ED.22 As for other complications of obesity, WC was superior to BMI in predicting ED,22 confirming the results from two previous studies.2627 "
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    ABSTRACT: Erectile dysfunction (ED) is a frequent complication of obesity. The aim of this review is to critically analyze the framework of obesity and ED, dissecting the connections between the two pathological entities. Current clinical evidence shows that obesity, and in particular central obesity, is associated with both arteriogenic ED and reduced testosterone (T) levels. It is conceivable that obesity-associated hypogonadism and increased cardiovascular risk might partially justify the higher prevalence of ED in overweight and obese individuals. Conversely, the psychological disturbances related to obesity do not seem to play a major role in the pathogenesis of obesity-related ED. However, both clinical and preclinical data show that the association between ED and visceral fat accumulation is independent from known obesity-associated comorbidities. Therefore, how visceral fat could impair penile microcirculation still remains unknown. This point is particularly relevant since central obesity in ED subjects categorizes individuals at high cardiovascular risk, especially in the youngest ones. The presence of ED in obese subjects might help healthcare professionals in convincing them to initiate a virtuous cycle, where the correction of sexual dysfunction will be the reward for improved lifestyle behavior. Unsatisfying sexual activity represents a meaningful, straightforward motivation for consulting healthcare professionals, who, in turn, should take advantage of the opportunity to encourage obese patients to treat, besides ED, the underlying unfavorable conditions, thus not only restoring erectile function, but also overall health.
    Asian Journal of Andrology 03/2014; 16(4). DOI:10.4103/1008-682X.126386 · 2.60 Impact Factor
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    • "Potential mechanisms explaining the association between obesity and sexual dysfunction include: endothelial dysfunction , metabolic syndrome and diabetes, endocrine disorders, obstructive sleep apnea syndrome, physical disability, and social and psychosocial problems [5]. Overweight and obesity have been identified as risk factors for sexual dysfunction only in men [4] [13] [14], whereas the relationship between female sexual function and excess fat remains to be better clarified [15] [16] [17] [18] [19]. "
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    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
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    ABSTRACT: We review the literature on the relationship between obesity and sexual functioning. Eleven population-basedstudies, 20 cross-sectional non-population-based studies,and16weight loss studies are reviewed.The consistency of findings suggests that the relationship between obesity and reduced sexual functioning is robust, despite diverse methods, instruments, and settings.In most population-based studies, erectile dysfunction (ED) is more common among obese men than among men of recommended weight. Studies of patients in clinical settings often include individuals with higher degrees of obesity, with most studies showing a relationship between obesity and lower levels of sexual functioning, especially ED. The few studies that include both gendersgenerally report more problems among women. Most studies of patients with comorbidities associated with obesity also find an association between obesity and reducedsexual functioning.Mostweight loss studies demonstrate improvement in sexual functioningconcurrent with weight reduction despite varying study designs, weight loss methods, and follow-up periods. We recommend that future studies (1) investigate differences and similarities between men and women with respect to obesity and sexual functioning, (2) use instruments that go beyond the assessment of sexual dysfunction to include additional concepts such as sexual satisfaction, interest, and arousal and, (3) assess how and the degree to which obese individuals are affected by sexual difficulties. Given the high prevalence of obesity and the inverse association between body mass and sexual functioning, we also recommend that sexual functioning should be more fully addressed by clinicians, both in general practice and in weight loss programs.
    Obesity 04/2012; 20(12). DOI:10.1038/oby.2012.104 · 3.73 Impact Factor
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