Obesity is a serious health issue that contributes to a wide range of medical problems, including sexual dysfunction. But how, exactly, does obesity affect sex? And can weight loss improve sexual function? Last spring, scientists from Valparaiso University in Indiana, USA published their review of data from biomedical, physiologic, and psychological databases that addressed these questions.
How Common Is Obesity?
For their article, overweight status was defined as a body mass index (BMI) equal to or greater than 25, with obesity defined as a BMI of 30 or above. Around the globe, an estimated 1 billion people are overweight, and 300 million are categorized as obese.
How Does Obesity Impact Sexual Function?
The researchers began with explanations of sexual response, obesity, and the regulation of adipose (fat) tissue. From there, they described the evidence that links obesity to sexual dysfunction. For example, obese women tend to have more frequent and more severe sexual problems than average-weight women, they said. Some of the most common female sexual complaints are low desire, poor arousal, inadequate lubrication, and sexual pain. In men, obesity plays a large role in erectile dysfunction (ED).
In both sexes, the behavior of adipose tissue may alter levels of testosterone, estrogen, and nitric oxide. In men, testosterone is connected to sex drive, erections, and penile sensation. Nitric oxide is also essential for erections.
The authors explained that the roles of these substances in the sexual function of obese women may be more difficult to determine. In addition, such roles in women may not be as influential as contextual and emotional factors related to sex.
It can be difficult to separate obesity’s direct effects on sexual function from those of comorbidities associated with obesity, such as metabolic syndrome, diabetes, and heart disease, the authors added.
How Does Obesity Impact Psychological Factors of Sexual Dysfunction?
When considering obesity and sexual function, psychological issues are also important. Obese people are frequently victims of stigma and ridicule, leading to poor body image and low self-esteem. Depression and anxiety are also common in this population.
How Can Treating Obesity Enhance Sexual Function?
Weight loss and exercise may improve sexual function in men, the authors said. Studies have shown that physical activity and a healthy diet may help increase testosterone levels and bring about better erections and higher sexual satisfaction.
Less is known about the effects of weight loss on the sexual function of women, but it’s possible that weight loss strategies may help.
Surgical weight loss might have sexual benefits, the authors wrote, but “not all data are consistent,” the authors wrote.
Future Research
In their conclusion, they pinpointed five areas that need closer investigation:
- Causal links between obesity and sexual problems
- Pre- and post-testing of sexual function
- Psychological variables
- The direct and indirect effects of obesity on sexual response
- Lifestyle changes and weight loss approaches
Conclusions
Overall, it is essential for healthcare providers to discuss obesity and sexual health with their patients, the authors said.
“Not only might they—in a non-castigating and supportive manner—point out the biological and psychological effects that decrease the desire for sexual engagement and sexual response, but they also are well positioned to discuss other health-related complications from obesity,” they wrote.
The study was published online in April 2017 in Sexual Medicine Reviews.
Resources
Sexual Medicine Reviews
Rowland, David L. PhD, et al.
“Sexual Function, Obesity, and Weight Loss in Men and Women”
(Full-text. Published online: April 26, 2017)
http://www.smr.jsexmed.org/article/S2050-0521(17)30036-7/fulltext