EFFECTS OF OBESITY IN SEX

When discussing obesity, it is common to focus on the well-known diseases often brought on by excess weight. Typically we hear about patients affected by severe obesity suffering from diabetes, hypertension/cardiovascular disease, sleep apnea or high cholesterol. Another side effect of obesity that is rarely openly discussed is sexual dysfunction for both men and women, which can originate from emotional distress and hormonal disturbances.

Risk Factors
Many men suffering from obesity also suffer from erectile dysfunction (E.D.). According to Ira Sharlip, MD, spokesperson for the American Urological Association, “Fifty-three percent of men between the ages of 40-70 have some degree of erectile dysfunction.” There are many risk factors for erectile dysfunction including:

• Age
• Cardiovascular disease
• High blood pressure
• Low testosterone
• Smoking and diabetes, along with a poor diet and sedentary lifestyle

With many conflicting studies, it is unclear whether a high body mass index (BMI) and obesity cause erectile dysfunction or are just tied to the associated risk factors, however, it is clear that obesity is a contributing factor. With significant health and lifestyle changes, erectile dysfunction can be significantly improved.
Simply with increased age alone, there is an associated natural decline in erectile function. If there are other diseases present, there is a greater risk. E.D. and sexual performance are great sources of anxiety and concern for all men. Poorly perceived performance leads to worsening performance and depression for even the most confident of men! Obesity can bring on these diseases and also magnify these psychological concerns.
How does an erection work?
Let’s first take a look at how erectile function normally works. An erection occurs when the blood vessels leading to the penis dilate, causing it to fill with blood. The process is dependent on the lining of the blood vessels (the endothelium) releasing nitric oxide (E.D. medications increase the amount of Nitric Oxide in the endothelial cells). Nitric Oxide causes the smooth muscles to relax and the penis becomes engorged.
Anything that damages the blood vessels can potentially interfere with this process resulting in E.D. So the same things that cause heart disease and stroke, can cause E.D.
Obesity and E.D.
Overweight/obesity can cause E.D. by damaging the blood vessels, decreasing testosterone and causing a state of generalized inflammation in the body. Obesity can cause damage to blood vessels due to the associated hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia and inflammation.
It is proposed that the increased state of inflammation may cause free radicals in the body that cause oxidative damage to tissues. The harmful effects of hypertension, diabetes and hyperlipidemia are well studied, published and accepted. Men who are affected by obesity may have elevated cholesterol, hypertension and high blood pressure and diabetes, all of which contribute to erectile dysfunction. “If you are affected by obesity, the risk of developing diabetes is two to three times more likely than for someone who is not affected by obesity,” says Elizabeth Selvin, PhD, MPH, assistant professor and epidemiologist at John Hopkins Bloomberg School of Public Health. Additionally, she says, “More than 50 percent of men with diabetes suffer from erectile dysfunction.”
It is well studied and accepted that obesity often leads to diabetes as well as atherosclerosis-related hypertension and cardiovascular disease, which can cause E.D. We do not know exactly why, but obesity appears to damage the inner lining of the vessels (the endothelium) and when this lining is damaged the penis cannot get enough blood flow to produce and sustain an erection. “An erection is basically a cardiovascular event, and if blood flow cannot increase because the blood vessels can’t dilate normally, then there is a decrease in erectile function,” says Robert A Kloner, MD, a cardiologist and professor of medicine at the University of Southern California’s Keck School of Medicine. A fatty diet and lack of exercise that contribute to obesity and cardiovascular disease can cause narrowing and hardening of the arteries (atherosclerosis), which can slow blood flow as well.

Another common risk factor for E.D. is low levels of testosterone, which is also linked to obesity. Appropriate levels of this hormone are necessary to achieve erections and maintain a healthy sex drive. When the patient has a large amount of belly fat, there is a greater affect on the testosterone levels. In males, abdominal fat will convert testosterone to estrogen interfering with proper hormonal balance. Testosterone levels may not be affected quickly and directly by weight-loss, so there may be a need for additional testosterone to be prescribed in the form of a gel, injections or patches.

The Good News
Research tells us that erectile function can be improved by making specific lifestyle changes! If you are affected by obesity, a BMI greater than 30, you are allowing yourself to be at greater risk for diabetes, high blood pressure, hypertension, cardiovascular disease and for men, erectile dysfunction. Eating healthy, exercising and not smoking can absolutely correct E.D. in many cases!
Men who lose weight have improved erectile function and improved sexual experiences along with improved overall health. Becoming more active and implementing exercise daily will reduce your risk and can prevent E.D. Research tells us that losing only 10 percent of body weight throughout a two month period will improve erectile function.

“Nobody said that it would be easy. They just promised it would be worth it!”
Now, I know that losing weight is not an easy thing to do. Many of you have struggled with your weight for your entire life. You may have tried every diet known to man and still suffer from obesity. You have to start where you are and seek help. Reach out to an accredited medically supervised weight-loss program and utilize their multidisciplinary team to create a program designed for you.

Perhaps it is time to consider consulting a physician or a surgeon to go over all your obesity treatment options. There are so many more surgical and non-surgical options available today than ever before that can help you begin your weight-loss journey.
One thing that is for sure, being sexually active and fulfilled is necessary for a happy, healthy life. If you are suffering from erectile dysfunction, seek help from a medical professional. Find out if you have any of the diseases that are associated with causing E.D. and seek treatment. If you are suffering from obesity and E.D., make a decision today to treat your disease of obesity with a plan of action. Get your mojo back! Begin to eat right and commit to move more each day. I challenge you to begin the journey to your New Life!

Hormonal imbalance leading to low libido
Obesity is directly linked to hormonal imbalance and lower testosterone levels, which in turn can inhibit sexual desires in both men and women. Another issue is that increased body fat leads to more sex hormone binding globulins (SHBG) in the system. SHBG is a natural chemical that binds to testosterone, which means that there is less of the sex hormone left to handle the demands of a normal sex life. There has also been evidence to suggest that obesity in young boys can lead to fatigue and development of male breasts. In young girls it can lead to PCOD, irregular menstrual cycle and thyroid problems.
Infertility
In women, obesity leads to abnormalities in their eggs that make them harder to fertilise. Brigham and Women’s Hospital infertility researchers examined nearly 300 eggs that failed to fertilise during IVF and found obese women’s eggs were likelier to have chromosomal abnormalities. It also causes excess insulin production and PCOD (a condition where the periods are irregular and ovaries produce small, immature eggs instead of healthy mature ones). Obese women are also likely to suffer from failed pregnancies and miscarriages than regular weighing ones. Here is how to combat vaginal dryness naturally to have pleasurable sex.
In men, obesity is directly linked to infertility because of the way it affects sperm. Research has found that men who consume a fatty diet have lower quality of sperm. Men consuming more saturated fats had 35 percent lower total sperm count and 38 percent lower sperm concentration than men who ate healthier.
Obesity-related diseases that hinder sex
People who are heavy, particularly in the central abdomen area tend to suffer from a host of diseases which can affect their sex lives in various ways. This can be due to physiological or psychological reasons or due to medicines taken for the disease. Diabetes, heart disease, cancer, hypertension, depression, dementia and other ailments all affect your sexual functioning. In fact, one of the most tell-tale symptoms of diabetes is erectile dysfunction. Medicines too, ranging from anti-depressants to those used to treat heart conditions, high blood pressure and cholesterol can lead to sexual issues like impotence,  decreased sex drive, ejaculation problems and even delayed or no orgasms.  Here’s a complete list of medicines that can affect your sexual life.
Buried penis syndrome
Folds of abdominal fat and skin in obese men make the penis look rather small or even ‘buried’ at times. Called the ‘buried penis syndrome’, it can seriously hamper sex lives. This however, should not be confused with the ‘micropenis’ which is a condition where the erect penis measures less than 3 inches. This is mostly a congenital disorder in children and can affect around 0.6% of the male population.
STDs and unwanted pregnancies
Since obese people are likely to have less sex than the others, they are likelier to exhibit high-risk sexual behaviour. An American study found that obese women were four times likelier to have unplanned pregnancies because they’re less likely to be prepared for intercourse. They are also less likely to use oral or other forms of contraceptives. A French study found a similar situation among obese men despite having lesser sexual partners.
Fewer sex positions possible
Sadly, the sheer logistics of sex can change when one or both partners are fat and can make coitus in some positions particularly hard. The popular missionary position is out-of-bounds if the male partner is too heavy. And if both partners are obese, then the central abdominal area can prevent proper penetration. The rear entry style which is more popular among the obese can also cause problems because the woman usually has to spend a long amount of time on her knees. Spooning, a sex position where partners lie side by side is also hard for fat people. However, fat people shouldn’t fret and there are multitudes of positions that they can try with their partners.  Here’s a great article I came across about modified sex positions.
Less likely to have sex
Let’s face it – we live in a society that judges us by our looks and obese people are always going to find it harder looking for a partner. The problem is even graver in a country like ours where it is okay for a man to be obese if he has a high-paying job or is from a rich family whereas it is almost impossible to find a groom for a ‘fat girl’.
Low self-esteem, depression and other conditions
We live in a society where obese people are routinely made fun of and termed as ‘lazy’, ‘stupid’, ‘dumb’ or ‘slow’. This kind of segregation starts when a person is very young and obesity becomes the defining characteristic of an individual irrespective of her other qualities. This labelling sticks for life and anyone who has faced childhood obesity is likely to develop very low self-esteem. This promotes a negative body image which makes obese people uncomfortable in their skins. How can you be comfortable having sex, if all your life you’ve been told you’re ugly? Also various studies have shown obese people are far likelier to suffer from depression and other mental health problems which reduce libido and are likely to cause sexual dysfunction.
Lack of stamina
Obesity is often associated with laziness and a sedentary lifestyle. And this may often percolate into their sex lives as well. In men, it will also significantly decrease the time they can maintain an erection.
To sum it up, I don’t want to seem harsh pointing out how being fat or obese can harm your sex life. I was grossly obese myself and still continue to face multiple body image issues. But the fact remains that you can improve your sex life by simply losing a few pounds. And this will not only benefit your sex life but your overall health and well-being as well. What you’ve to realise is that the entire situation is in your own hand; you’re in control of your weight and you can choose to lose it whenever your heart desires.