Sexual function and obesity

Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, Copenhagen, Denmark.
International Journal of Obesity (Impact Factor: 5). 09/2007; 31(8):1189-98. DOI: 10.1038/sj.ijo.0803604
Source: PubMed


To review the literature on the relationship between obesity and sexual function.
A search in the medical literature from 1966 and onwards was carried out through Medline and Embase for publications on obesity, in combination with Medical Subject Heading words related to sexual function and dysfunction.
Four prospective and seven cross-sectional studies were found describing association between obesity and erectile dysfunction (ED). One cross-sectional study was found describing obesity and female sexual dysfunction (FSD). The prospective studies on ED all demonstrated a direct association and so did five of the seven cross-sectional studies. The single FSD study did not find any relationship. Eight intervention studies on weight loss and sexual difficulties were identified. All included few individuals and results were mixed even if most indicated an increase of sexual activity among both men and women after weight loss intervention.
Support for the assumption that obesity is associated with ED was found in both prospective and cross-sectional studies. FSD was not adequately described in the literature and prospective studies are needed here. Results from weight loss intervention studies are less conclusive, but also point toward improvement in sexual dysfunction with reduced weight.

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Available from: Berit Lilienthal Heitmann, Dec 11, 2015
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    • "The close association between the two conditions was further strengthened by observations derived from longitudinal studies. In fact, having obesity at study entry was a significant predictor of incident ED at follow-up in both US and European populations.24 "
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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.
    Full-text · Article · Mar 2014 · Asian Journal of Andrology
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    • "A number of obesityrelated comorbidities, such as dyslipidemia, hypertension, type 2 diabetes, and depression, are associated with sexual dysfunction [9] [10] [11] [12]; hence, it is difficult to identify the role of obesity per se in the development of sexual dysfunction. 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.
    Full-text · Article · Feb 2014 · International Journal of Endocrinology
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    • "Obesity may affect men's sexual experiences via physiological as well as psychological pathways. Obese men have elevated risks of a range of physical conditions including erectile dysfunction, or the persistent inability to attain and maintain a penile erection adequate for satisfactory sexual performance (Larsen, Wagner, and Heitmann 2007); infertility (MacDonald et al. 2010); and reduced testosterone levels (Isidori et al. 2005). Each of these conditions may compromise both physical and emotional aspects of sexual satisfaction. "
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    ABSTRACT: We use data from the Midlife Development in the United States study to examine how sexual satisfaction, frequency, and number of partners are associated with men’s body weight. We consider five body weight categories (underweight, normal, overweight, obese I, and obese II/III), and control for potential explanatory factors including demographic characteristics, socioeconomic status, health, perceived stigmatization, and adolescent weight. Obese II/III men report significantly less sexual satisfaction and less frequent sexual activity, and a greater likelihood of having no sex partner compared to normal weight men. Physical and mental health conditions partially account for obese II/III men’s less satisfying and less frequent sex. However, the deleterious effects of obesity are suppressed by youthful weight. Obese II/III men are more likely to have been overweight adolescents, an attribute associated with more frequent and satisfying sex in adulthood. We discuss implications for the study of masculinities, and the ways that bodies and their symbolic meanings can shape men’s sexual lives.
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