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quality of life, sex, and obesity


Obesity and Sex    Obesity and Sex    

“Obesity is a disabling disease with significant sequelae in multiple domains, and our results suggest the need of awareness toward obesity-related disability and its impact on sexual life in obese subjects.” The conclusion of an Italian study (Health-Related Quality of Life and Quality of Sexual Life in Obese Subjects) published in a 2014 issue of the International Journal of Endocrinology.

“Sex hormone-binding globulin (SHBG) is a plasma glycoprotein with high binding affinity for testosterone.  Obesity and particularly excess visceral fat, known risk factors for cardiovascular and metabolic diseases, are associated with decreased testosterone levels in males and SHBG levels in both sexes. 

A positive association between SHBG and various measures of insulin sensitivity has been demonstrated in both sexes, suggesting that decreased SHBG levels may be one of the components of the metabolic syndrome.”   From a study (Synthesis and Regulation of Sex Hormone-Binding Globulin in Obesity) published in the June 2000 issue of the International Journal of Obesity and Related Metabolic Disorders.

When it comes to low libido (one aspect of sexual dysfunction), probably nothing is more to blame than OBESITY.   This is not new information and should come as no surprise — particularly when it comes to men. Unfortunately, it’s becoming increasingly apparent that the same thing is true for women as well. 

For decades, women — whether overweight / obese or normal weight — have been told that their problems in the bedroom are mostly “psychological“,  Or they’re simply blamed on “hormones“, which honestly, could mean almost anything.  Although I certainly don’t want to discount either of these issues, I want people to realize that for both sexes, Sexual Dysfunction is largely physical, and that there are a number of things that can be done to turn this problem around.

No matter how you slice it, study after study after study links quality of life to sexual frequency and enjoyment.  In fact, the Farlex Partner Medical Dictionary defines the term “Quality of Life” as “A patient’s general well-being, including mental status, stress level, sexual function, and self-perceived health status.”  We know that DEPRESSION is rampant in this country.  We also know that Americans are maximally stressed out.  To top it all off, statistics show us that massive numbers of us have poor sex lives. 

How are most physicians treating these folks?  You already know the answer.  In typical “EVIDENCE-BASED MEDICINE” fashion, this group (especially the women) are given Antidepressants —- the proverbial “anti-aphrodisiac” — one of the WORST CLASSES OF DRUGS for further destroying sex drive.

It was a decade ago next month that Dr. Martin Binks, the director of behavioral health at Duke University Medical Center’s Diet & Fitness Center, published his landmark study on Obesity and Sex.  In this study he showed that Obese individuals were 2,500% more likely to report having problems with their sex life than people of normal weight, and that women had greater problems in this particular area of sexual dysfunction than men.  

Then, in 2007, several researchers from Copenhagen’s Institute of Preventive Medicine published a paper in the International Journal of Obesity (Sexual Function and Obesity).  Although they did not do any new research for this paper, they reviewed all the previous studies on the topic from 1966 forward, coming to some conclusions of their own.  I am going to leave you with some quotes from their literature review.

  • 10–30% of all individuals from developed countries are obese. In addition, 1/3–2/3 are considered to be overweight.
  • There are indicators that obesity may cause sexual dysfunction.
  • Most [of the studies reviewed] indicated an increase of sexual activity among both men and women after weight loss intervention.
  • After mentioning a plethora of health problems related to Obesity, the study’s authors stated, “Sexual dysfunctions may also relate to obesity, but are rarely mentioned, and may, for both individual and partner, cause concern and constitute a great problem.  Obesity is also rarely mentioned as a co-factor to sexual problems in textbooks on human sexuality, and, if so, with no reference to data in support of a causal relationship”.
  • Obesity is a known independent risk factor for vascular risk factors such as dyslipidemia, hypertension, diabetes mellitus and depression, all known to be directly related to sexual dysfunction in both women and men….
  • Obesity is directly related to Erectile Dysfunction [in obese men].
  • In the male population, the odds of “developing ED among the more overweight compared to the lean,” are significantly greater.
  • Obesity…. was a significant predictor of subsequent ED, and that this association was independent of age and hypercholesterolemia [HIGH CHOLSTEROL — make sure to click this link if you are taking Statin Drugs to lower your Cholesterol].  Those treated with hypolipidemic drugs (especially fibrates and/or statins), more often complained about ED compared to a control group. Additionally, a systematic review from 2002 of the effect of lipid-lowering drugs on ED concluded that statins and fibrates might cause ED.” [Again, click the link.]
  • After adjusting for age, “A positive linear trend from no ED to severe/complete ED and no sexual activity was found with increasing BMI [BODY MASS INDEX]“.
  • The results suggested that the quality of residual erectile function was significantly better in the non-obese than in the obese group.
  • ED occurred significantly more often in men with high BMI than in men with lower BMI.
  • They demonstrated a significantly decreased reaction to increased level of C-reactive protein in the obese [C-Reactive Protein is one of the markers of SYSTEMIC INFLAMMATION — which is a known cause of Obesity and Sexual Dysfunction (click on the link).  By the way, there was also a study on Cytokines (another component of many Inflammatory reactions) and ED].
  • The results showed that 31% of the obese men and 31% of the obese women reported problems with their sex life.”  [This number was over 100% higher than the “normal weight” group].
  • There was a tendency toward lower sexual satisfaction and sexual desire associated with higher weights in the youngest age group [18-49].
  • Most of the studies among men suggest a positive association between obesity and sexual dysfunction.
  • The pilot among women studies by Werlinger demonstrated that weight loss significantly increased the overall perception of sexual functioning and increased sexual satisfaction.
  • A number of different sexual difficulties may arise with obesity in men and women. For both genders, these include difficulties with lack of orgasm, decreased intercourse frequency, reduced sexual desire and lack of perceived satisfaction.  In women, dyspareunia [painful intercourse] and decreased vaginal lubrication may occur.
  • Watching television for more than 20 hours per week was significantly associated with ED.
  • Women who were satisfied with their body image reported more sexual activity, more frequent orgasm, comfort with having sex with lights on and with pleasing their partner sexually.  Stress and depression could have an influence on the desire, but a low self-esteem from dissatisfaction of body image may also affect the desire.
  • Women with the metabolic syndrome had an increased prevalence of sexual dysfunction compared to controls.
  • Obesity has been found to be associated with increased androgen production among women, whereas studies in men show a low androgen production [they are talking about PCOS in women -vs- LOW TESTOSTERONE in men.]
  • Most weight loss intervention studies suggest that weight loss improves sexual functioning in women as well as in men.
  • A number of biological mechanisms may link obesity to sexual dysfunction

In light of the fact that the authors say that there is not enough “research” into the link between Obesity and Sexual Dysfunction, this last bullet point above provides us direction.   While there have been large numbers of studies done on SEXUAL DYSFUNCTION and Obesity in men, there have not been nearly as many in women. 

On top of this, there is a pervasive idea in the scientific community that goes like this (I will quote from an article called Obesity and Sex found in an ad for a weight loss product).  “Obesity does not, by itself, lead to a bad sex life. However, there are physical conditions that go hand-in-hand with obesity that can cause such problems.”  

For the sake of argument, let’s say that this statement and statements like it from the scientific literature are true.  What’s the difference and what does it matter?  Whether Sexual Dysfunction is being caused by Obesity itself or by the complications / sequelae thereof is a moot point, as the end result is the same.  On top of all this, Obesity itself is an “Inflammatory” problem, and we know that Sexual Dysfunction is yet another one of those things related to Inflammation (HERE).  But this is just the beginning.

What are the “biological mechanisms” they are talking about in that final bullet point above?  I will give them to you verbatim, with links to articles from my site.  “Endothelial Dysfunction [another marker of Systemic Inflammation that is directly related to decreased blood flow], METABOLIC SYNDROME, DIABETES, ALTERED ENDOCRINE FUNCTION, PSYCHOLOGICAL PROBLEMS, SLEEP APNEA, Physical Disabilities” (too many to list, but I will leave you with ONE).  Furthermore, if we were to look at each individual study, we would find many more that could be added to this list.

But all of this begs a critical question.  With a whopping 70% of Adult Americans either Obese or overweight, and another 8% MONW, (not to mention the ASTRONOMICAL NUMBERS of individuals dealing with some sort of Sexual Dysfunction), how do we get there from here?  In other words, what sort of strategies can be used to regain the “Quality of Life” that a healthy sex life helps bring to the table, by shedding excess pounds?  Glad you asked.

I have a significant number of posts on WEIGHT LOSS, which you can read at your leisure.  There are a wide variety of strategies in those posts, including things like controlling Blood Sugar and Inflammation by going LOW CARB / PALEO, addressing GUT HEALTH, making sure to add RESISTANCE TRAINING to your workout regimen, and many others.  And if you are dealing with BELLY FAT, it will be almost impossible to get your bedroom mojo back unless you deal with it first. 

You see, Belly Fat, the deep fat packed in around your organs, is bad news because it is far more metabolically active than the fat that is found on hips, thighs, etc (it actually produces Estrogen — see the previous link).  Get rid of your Belly Fat and your Endocrine System (including your OVARIES, your HYPOTHALAMUS, your ADRENAL GLANDS, and your THYROID), will work more like it should — without drugs or nutritional supplements.  The really awesome thing about this approach is that it is the same approach you would use to deal with almost any health problem you are struggling with (HERE).

Granted, each individual is different and may require some personalized attention and specific supplements.  But the bottom line is that eating the right foods, and exercising in the correct manner is going to boost the metabolism, increase blood flow to the sex organs (a problem that is universal to both men and women, even though it used to be thought of as a “male” issue), and increase one’s energy (including sexual energy).  I have yet to hear a patient (male or female) tell me that this or similar approaches have not helped them.

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