The Impact of Overweight and Obesity on Sexual Function
I believe overweight and obesity might not be unfamiliar terms nowadays. Obesity affects millions of people and causes a wide range of health conditions. Among these, the impact on sexual function is often overlooked. This article will explore the causes, consequences, and potential solutions to this problem, aiming to improve sexual wellbeing through weight management.
Welcome to the Holmen’s Health dietitian blog post, I am dietitian Oscar and here we talk about foods, drinks, snacks, desserts, anything that you can think of when it comes to eating. I personally love eating and am passionate about assisting others in finding their most suitable diet pattern while promoting maximum health benefits. Let’s explore how obesity impacts sexual function.
Causes: How Obesity Affects Sexual Function
The term obesity is often heard, but what exactly does it mean? Different ranges of weight can be determined by an indicator called body mass index (BMI), which is calculated using height and weight but does not consider muscle mass. A recommended BMI range falls between 18.5 to 24.9, a BMI of 25 or above is classified as overweight, while a BMI above 29.9 is classified as obese. Being overweight or obese significantly raises the risk of heart diseases, type 2 diabetes, kidney disease, and one of the most overlooked complications: sexual health problems. Obesity impacts sexual health in various ways, including the following three pathways.
1. Hormonal Imbalances
Fat accumulation is a common characteristic among obese individuals, especially around the abdomen. Excessive body fat can disturb the balance of sex hormones, including androgens and estrogens. Moreover, obese individuals have shown higher levels of adipokines, substances secreted by body fat, which can negatively impact sperm function and fertility.2. Circulatory System
The heart and blood flow are closely linked to sexual function, as good blood flow is required to maintain erectile hardness. However, cardiovascular disease is one of the most common complications of obesity and can heavily impact the circulatory system, thus affecting sexual function.3. Insulin Resistance and Diabetes
Obesity can also lead to insulin resistance and ultimately type 2 diabetes. With diabetes, nerve damages often occur, which can be detrimental to sexual function if the nerves around the penis are damaged. Additionally, individuals with poor glycemic control and insulin resistance are more prone to encountering sexual dysfunctions.
Consequences:
One of the most extreme treatments for obesity is undergoing bariatric surgery, which aims to decrease the volume of the digestive system so that less food can be consumed. However, bear in mind that this is not suitable for everyone, so please consult healthcare professionals if you wish to pursue this option. A study conducted in 2016 investigated 2,225 individuals who had previously undergone bariatric surgery, and more than 40% of men claimed that their physical health had limited their sexual activity. It might appear that the bariatric surgery itself causes all the problems. However, the issue begins with obesity harming the body, and bariatric surgery is just a measure taken when the condition has reached its most severe stage.
1. Erectile Dysfunction
A study conducted in 2023 examined 878 men using the International Index of Erectile Function (IIEF) scores and found a positive correlation between obesity and moderate to severe erectile dysfunction. Numerous factors contribute to erectile dysfunction, including poor lifestyles leading to obesity, excessive fat accumulation, and bariatric surgery. One possible explanation could be the impact of obesity on cardiovascular function, affecting blood flow to the penis and causing erectile dysfunction.2. Low Sexual Desire
Obesity affects not only the body’s internal systems but also its external appearance. Some individuals suffering from obesity might feel concerned about their physical appearance and body image, leading to reduced sexual desire and sexual activity. Research from 2019 suggested that these individuals might also feel reluctant to undress with their partners or encounter body image dissatisfaction, making them hesitant to engage in sexual activity.3. Infertility
Current scientific evidence has shown a strong impact of obesity on reducing fertility and embryo health. A 2012 scientific review illustrated that couples with an overweight or obese male partner, even with a female of the recommended weight range, require a longer time to conceive compared with couples within the recommended weight range. The reason behind this is that obesity can affect embryo development, sperm binding and fertilisation rates.Solutions: Road to Improve Sexual Function
Although these all outcomes might sound devastating and scary, they are not irreversible. With a comprehensive approach focusing on weight management and lifestyle changes, it is never too late to make a difference. A 2-year study conducted in 2009 followed 187 bariatric surgery patients who received regular care by dietitians, including customised diet plans, exercise regime, and medication. The results were significant: the average weight loss over 2 years was more than 13%, and both the sexual attractiveness and sexual functioning were enhanced. The core idea is to pinpoint the areas of improvement and give your best effort to maximise the effectiveness of improving sexual function.
1. Healthy Diet
The first thing of course is diet, as foods are directly linked to energy balance, a crucial indicator of weight. The more food consumed, the more positive the energy balance. Without adequate energy expenditure, excessive energy intake will turn into fat storage, leading to weight gain. A study conducted in Singapore examined the effects of a low-energy diet on sexual function in obese men. The results showed that around 10% of weight loss could significantly improve insulin sensitivity, blood testosterone level, and IIEF score.2. Medical Intervention
Despite diet, medication can also be an effective solution. As science and technology evolve at a fast pace, many new medications are being developed. A study conducted in 2023 tested a new medication, Liraglutide, aimed at treating hypogonadism (low sex hormones) in obese male. The preliminary results showed a positive effect on sexual function, including improved erectile function and increasing testosterone levels.3. Regular Health Check-ups
Monitoring is also an important element of sexual health, as many obesity-related medical complications, including diabetes, hypertension, and cardiovascular diseases, can impact sexual health. Regular check-up can help monitor and manage these conditions as well as assess the sexual function. So, please remember to visit a healthcare provider regularly.If you’re wanting support in learning how to improve your diet to support sexual function, learn more about our philosophy and services, please reach out to us! We work with clients virtually throughout Australia. This blog post on the Impact of Overweight and Obesity on Sexual Function was published June 2024.Book a FREE appointment
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- Department of Health and Aged Care. (2021, February 25). About overweight and obesity. Australian Government Department of Health and Aged Care. https://www.health.gov.au/topics/overweight-and-obesity/about
- Khoo, J., Piantadosi, C., Worthley, S. G., & Wittert, G. (2010). Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men. International Journal of Obesity, 34(9), 1396–1403. https://doi.org/10.1038/ijo.2010.76
- Kolotkin, R. L., Crosby, R. D., Gress, R. E., Hunt, S. C., & Adams, T. D. (2009). Two-year changes in health-related quality of life in gastric bypass patients compared with severely obese controls. Surgery for Obesity and Related Diseases, 5(2), 250–256. https://doi.org/10.1016/j.soard.2009.01.009
- Liu, Y., Hu, X., Xiong, M., Li, J., Jiang, X., Wan, Y., Bai, S., & Zhang, X. (2023). Association of BMI with erectile dysfunction: A cross-sectional study of men from an andrology clinic. Front. Endocrinol., 14. https://doi.org/10.3389/fendo.2023.1135024
- Palmer, N. O., Bakos, H. W., Fullston, T., & Lane, M. (2012). Impact of obesity on male fertility, sperm function and molecular composition. Spermatogenesis, 2(4), 253–263. https://doi.org/10.4161/spmg.21362
