Weight and erectile dysfunction

Is obesity linked to erectile dysfunction?

When talking about health complications and the risks that come with being overweight, things like heart attack, stroke, and cancer are often the first that come to mind. But did you know that obesity can also be linked to erectile dysfunction? If obesity is affecting your sex life, it’s important to know the facts about the effects of body weight on ED, along with available treatment options.

Before we dig into why being overweight can lead to difficulties getting an erection, it’s important that you understand what erectile dysfunction is in the first place. An erection begins in the brain when the nerves send signals through the body. The signals relax the arteries, allowing more blood to flow into the penis, creating pressure in the corpora cavernosa. The penis then hardens, resulting in an erection. ED is the inability to achieve or maintain an erection sufficient enough for masturbation or sex. ED is caused by a number of things, however, it’s almost always caused by the brain’s inability to send the right signals to the body. This results in a lack of blood flow to the penis.

While there are no studies that prove being overweight causes erectile dysfunction directly, it does affect blood flow to the penis which is vital for an erection. If blood cannot freely and readily flow to the penis, there will be no erection. In some cases, ED may even be one of the first signs of heart disease or other serious health conditions. Obesity is also a leading factor in high cholesterol and diabetes, which are two other conditions closely linked to ED. Studies also show a correlation between obesity and lower levels of testosterone, a hormone which is vital for normal sexual performance and libido in men.

Obesity and the mind

Let’s face it, when you don’t feel the best, your body doesn’t perform at it’s best. Carrying extra weight can lead to body image issues which can be damaging to the psyche and affect a guy’s ability to perform in the bedroom. Performance anxiety and confidence issues can manifest as ED symptoms and make it difficult to get an erection.

How to treat ED caused by obesity

Luckily, erectile dysfunction is treatable, especially when tied to being overweight, which can be remedied by lifestyle changes. A 2014 study showed that for those who are overweight and suffer from ED, an improvement in physical activity combined with a reduction in body weight is often an effective treatment method. Losing weight may help increase blood flow throughout the body and may even affect testosterone by improving levels of this much-needed hormone rather than decreasing them. It’s important to discuss your personal experience with your doctor to find out the appropriate body mass index number (BMI) for you.

If lifestyle changes aren’t doing the trick for your erectile dysfunction and weight issues, there are other treatment options like Giddy that are free of the negative side effects of ED drugs, and are usually more affordable. Traditional constriction rings can cause discomfort and unnatural ejaculation, while Giddy’s patented shape and design is meant to allow for better blood flow, and more free-flowing ejaculation. Penile implants and surgery are some of the more extreme and expensive options.

Being sexually active and confident is important in our relationships with our partners and ourselves, and ED can get in the way of that. Both weight and ED can be hard to talk about, but the more we openly discuss the causes and treatment options for men living with erectile dysfunction, the sooner everyone can get back to having a happy, healthy sex life.

Spare tire, beer belly or middle-aged spread – whatever you want to call it – belly fat is a problem that affects a large number of men. But this is one instance where you do not want to be one of the crowd. Carrying excess weight – especially belly fat – can pose serious health risks.

The danger of belly fat

It is one thing to carry excess weight throughout the body but it’s another when it is concentrated in the abdominal area, also known as central obesity. When a man gains weight, it almost always accumulates in the belly area.

Excess body fat in the belly region disrupts the normal balance of hormones in the body

The problem with belly fat is that it’s not limited to the extra layer of padding located just below the skin. The excess fat pounds stored as belly fat are located deep within the abdominal region in and around major organs like the liver and pancreas. This deeply stored fat has its own special name called visceral fat. Visceral fat is worse for your health than fat located anywhere else in the body. It is the type of fat that increases a man’s risk for certain chronic diseases.

How a man can tell if he has visceral fat

You may think you can tell if you have too much belly fat just by looking at your stomach. But a more conclusive way is to use a tape measure. Place the tape around the largest diameter of your belly – where a belt goes – to get an accurate measure. A man with a waist circumference 40 inches (101 centimeters) or greater has too much visceral fat and is putting his health at risk.

Three major health risks

1. Diabetes

Research has shown that fat cells, particularly abdominal fat cells, are biologically active. This excess body fat in the belly region disrupts the normal balance and functioning of various hormones in the body.

Scientists have learned that excess visceral fat pumps out immune system chemicals called cytokines that are thought to have a harmful effect on a cells’ ability to absorb insulin. This is known as insulin resistance. This means the body’s muscle and liver cells are not responding adequately to normal levels of insulin – the hormone the pancreas secretes whenever blood glucose rises and the key to ensuring glucose passes from the bloodstream and into the cells. When glucose is unable to do this, glucose levels in the blood continue to rise, heightening the risk of diabetes.

2. Heart disease

It is well-known that carrying too much weight in the central abdominal area is linked to heart disease but a study has shown that an increase in waist size also hurts the functioning of the heart’s left ventricle. The left ventricle is one of the heart’s four chambers and is responsible for pumping oxygenated blood to tissue throughout the body. It’s the heart’s main pumping chamber. An abnormality in the left ventricle is a common cause of heart disease including congestive heart failure.

Excess visceral fat can also lead to a higher risk for developing high blood pressure.

3. Erectile dysfunction

One way excess belly fat influences a man’s sex life is by decreasing the amount of blood that flows to the penis. An erection occurs when the blood vessels leading to the penis dilate, causing it to fill with blood. The penis must store blood in order to keep an erection. Therefore, a man’s ability to develop and maintain a penile erection depends on the health of his vascular system.

A man’s ability to a penile erection depends on the health of his vascular system

Another factor affecting his health is the endothelium – the thin layer of cells that line the interior surface of all blood vessels. If the endothelium is damaged by excess belly fat, it may not release enough nitric oxide – a molecule that signals the surrounding muscles to relax in order for the blood vessels to dilate and create an erection.

Carrying excess weight can also affect erectile dysfunction by lowering testosterone levels. Testosterone is the primary sex hormone in men and plays an important role in libido and sexual function.

How to reduce belly fat

Reducing waist size is imperative to reducing your risk of chronic health conditions. It won’t happen overnight but the sooner you begin working on losing your belly fat, the sooner you lower your chance of developing heart disease. Here are some ways you can reduce your waist size:

  • Eat regular nutritious meals – Avoid skipping meals and keep mealtimes as consistent as possible. This reduces the hunger pangs which lead you to crave high-calorie, convenience foods such as chips, sweets, or other foods and beverages high in fat, sugar, and calories. Going no more than four hours without eating helps stabilize blood sugars and keeps your metabolism running smoothly.
  • Keep portion sizes in check – Even when making healthy choices, calories can add up. Following the MyPlate method is a good way to ensure you are eating a balanced meal. Under this method, half of the plate is vegetables, one-fourth is a lean protein and the other one-fourth is a healthy starch or whole grain.
  • Replace sugary beverages – Drink water or unsweetened tea instead of soda, sports drinks, energy drinks, lemonade, or any other drink with sugar in it.
  • Limit alcohol intake – It’s not that beer or any other beverage containing alcohol can turn a trim waistline into a beer belly. Any kind of calories – whether from alcohol, sugary beverage, or oversized portions of food – can increase belly fat. However, alcohol intake is associated with bigger waists, because when you drink alcohol, the liver burns alcohol instead of fat. Also, a typical beer contains 150 calories and if a man downs several in one sitting, that’s a serious calorie overload. And don’t forget calories from food men use to wash down with alcohol – pizza, wings, and other fried foods. It all adds up very quickly.
  • Focus on 30 grams of fiber daily – Choose more fruits, vegetables, whole grains, nuts, and beans. These foods are full of fiber, taking longer to digest and making you feel fuller for longer. Aim to eat at least two fruits, two vegetables and a small handful of nuts each day and use beans in at least one meal a day.
  • Exercise regularly – Aim to do at least 150 minutes of moderate to vigorous exercise a week. Break this into 30 minutes of exercise five days a week. The greater the frequency, duration and intensity of physical activity, the more weight you will lose, particularly in the abdominal area.

Weight and ED: How Being Overweight Can Affect Your Erection

Worried about your ability to develop and sustain an erection? Erectile dysfunction (or ED) is a common condition that can affect men of all ages and backgrounds, making sexual activity less enjoyable.

Medical studies have revealed that several health factors are closely linked to ED. One of these factors is weight — for the most part, being overweight or obese is closely linked to a higher rate of ED in men of all ages.

In this guide, we’ll look at the links between being overweight and developing ED, as well as the most effective ways to improve your erection quality, sexual performance and general quality of life.

Do Health Issues Caused by Being Overweight Cause ED?

While there’s no scientific data showing that being overweight directly causes ED, some studies show a clear link between weight loss and improvements in sexual performance.

There’s also a wealth of epidemiologic linking risk factors for heart disease, such as high blood pressure and obesity, with erectile dysfunction.

For example, an Italian study of overweight and obese men looked at the effects of weight loss on erectile dysfunction. The men were divided into two groups — one of which received expert help on weight loss and exercise, while the others received only minor written help.

Men that were coached on weight loss lost an average of 33 lbs over a two year period, with the members of the control group losing an average of fewer than 5 lbs over the same period.

After two years, 31% of men in the group that lost an average of 33 lbs each reported restored erectile function. Only 5% of men in the control group showed similar improvements.

More recent research from the University of Adelaide shows similar findings — that men who are overweight or obese have a incidence rate for erectile dysfunction, but that this ED can often be treated through improvements in physical activity and a reduction in body weight.

In short, while there isn’t any scientific evidence to show that being overweight is a direct cause of erectile dysfunction, the negative health effects of obesity — high blood pressure, cholesterol and diabetes — are all closely linked to erectile dysfunction, making it a major risk factor.

Obesity and Testosterone Levels in Men

Beyond the negative cardiovascular health effects of being overweight, researchers also believe that the effects of obesity on testosterone could contribute to erectile dysfunction.

Obesity is closely linked to lower-than-normal levels of testosterone in men. A 2009 study shows that BMI (body mass index, a measure of body weight relative to height) is inversely proportional to serum total testosterone concentrations.

Other studies show a similar link between obesity and testosterone. One study from 1977 found that severely obese men had low levels of serum testosterone. A more recent review of medical study data from 2014 ended with similar findings.

In short, men with higher-than-average body weight tend to have lower levels of serum and free testosterone, a vital hormone for normal sexual performance in men.

Testosterone is closely linked to libido in men, with low levels of testosterone generally resulting in a reduction in sexual desire. There’s also some data to suggest that a certain baseline level of testosterone is essential for normal erectile function, making it a potential factor for ED.

The solution? Just like the men in the obesity studies linked above, men that lose fat and reduce their body weight through diet and lifestyle changes tend to show improvements in testosterone production.

In the Diabetes Prevention Program multicenter clinical research study, obese men were put on a diet and exercise weight loss program. Over the course of one year, men that lost weight with diet and exercise showed a small but significant increase in bioavailable testosterone levels.

This increase in testosterone didn’t occur in the placebo or medication treated groups, showing that weight loss and physical activity could be a major factors in healthy testosterone levels for men.

Overweight? How You Can Improve Your Erection Quality

Are you overweight or obese? Confirming your risk for obesity and related health problems isn’t as straightforward as it should be.

The BMI (Body Mass Index) is still widely referred to in the medical field, but it has its drawbacks. For instance, it doesn’t take body fat percentage into account. This can cause a muscular bodybuilder and an obese individual to have the same BMI number. Obviously, that’s an issue but keep in mind that most of us are not walking around looking like Arnold Schwarzenegger. Here is a simple BMI calculator from the U.S. Department of Health and Human Services.

To give yourself another data point you could also measure your waist to hip ratio which can give you more information about your current weight and body composition. Here’s an article from healthline that explains how to take the measurement and what the numbers mean.

If both your BMI and waist to hip ratio are outside the healthy range you could be at a greater risk for weight related health issues.

If you’re overweight, making a few small changes to your lifestyle and diet could have significant effects on your sexual performance:

  • Lose weight, either through dieting, exercise or a combination of both. Weight loss is closely linked to improvements in erection quality and sexual performance, making a healthy body weight an important factor for improving your sex life.
  • Focus on cardiovascular health factors. Cardiovascular issues like hypertension (high blood pressure) and high cholesterol are closely linked to erectile dysfunction, making any improvement to your heart health a positive for your sexual performance.
    You can learn more about this in our guide to high blood pressure and ED, which covers one of the most common causes of erectile dysfunction.
  • Exercise. Even if you aren’t aiming to lose weight, exercising regularly can improve your mood and help you relax during sexual activity, reducing the risk of performance anxiety and increasing your stamina.
  • Consider using ED medication. If losing weight and improving your cardiovascular health doesn’t completely solve your ED, medications like sildenafil, tadalafil and vardenafil can help you improve your erections and gain more confidence in bed. Just make sure you talk with your doctor first to make sure that you’re healthy enough to use ED medications.

For both sexual and all-round health, it’s always best to maintain a healthy body weight. If your weight has crept up over the last few years, bringing it down to a healthy level can have a major positive effect on your erections, sexual performance and general quality of life.

Gain Weight, Lose Your Sex Life?

Erectile dysfunction, or ED, is one of the most common chronic conditions men face. It’s estimated that 18 million men older than 20 experience it to some degree. Yet those numbers don’t lessen the anxiety you feel when it happens to you.

Men experience ED in different ways, but in general, erectile dysfunction is the inability to achieve or maintain an erection for desired sexual activity. Though various things can cause ED, there’s a consistently strong connection between obesity and sexual dysfunction – obese men are 2½ times more likely to experience ED than those of normal weight.

Obesity refers to body weight that is far above what is considered healthy. However, you could start to notice a variety of health issues, including ED, by being just 30 pounds overweight.

Obesity and Erectile Dysfunction: A Real Downer

The effects of weight gain on your sex life are twofold. First, obesity predisposes you to cardiovascular conditions such as atherosclerosis – cholesterol deposits on the walls of blood vessels that impede blood flow to your organs, including the penis. Second, obese men have lower levels of testosterone, a male hormone vital to sexual function. This affects the ability to achieve erections because you need testosterone to increase the availability of nitric oxide, a blood vessel dilator in penile tissue.

In fact, the connection between heart health and sexual health is so strong that erectile dysfunction can often be the first sign of cardiovascular disease in overweight men. Researchers at the Institute of Cardiology at the University of Milan found that nearly all men who had coronary artery disease had experienced ED an average of 2 to 3 years before developing heart symptoms. Also, doctors at the University of Texas Health Science Center at San Antonio found that because of its connection to obesity, erectile dysfunction may be a predictor of future heart attacks and strokes.

According to a study done at the Center for Men’s Health at Brown University in Providence, R.I., men typically first visit the doctor because of sexual complaints. So use erectile dysfunction as your opportunity to address your overall health – think of it as your body’s way of telling you it’s time to get a thorough checkup.

Obesity and Erectile Dysfunction: The Psychological Fallout

Being overweight can also place psychological obstacles between you and a healthy sex life. Because of decreased testosterone levels, you may be experiencing low libido, a depressed mood, and decreased energy. These factors conspire to further inhibit your ability and, as importantly, your desire to have a satisfying sex life. Men even report a diminished sense of vitality and well-being.

Weight Loss: Your Therapy for Erectile Dysfunction

Ready to regain your sex life? Then it’s time to shed that extra weight. Researchers at the Center for Obesity Management in Naples, Italy, found that weight loss improved sexual function in one-third of obese men.

Though the idea of weight loss can be overwhelming, the rules are actually simple. First, take a look at how much you eat. Ideally, aim to lose 1 or 2 pounds a week, which means cutting out 500 to 1,000 calories each day. That’s right – it’s time to read those dreaded nutrition labels.

Next, watch whatyou eat. Get rid of those chips and dips and cozy up to some greens and other raw veggies when you want to snack. Ditch the red and processed meats and try a fish filet instead. Switch up your white bread and pasta for some whole grains. Italian researchers found that thesediet principles – the basis for the healthful Mediterranean diet – are very effective in improving ED in people with obesity.

Last, but not least, get a move on. Physical activity is a must for any successful weight-loss strategy. The numbers speak for themselves: Highly active men have 30 percent less risk for ED than couch potatoes. Don’t have time? Just skip a few episodes of your favorite TV shows and get active for 30 to 45 minutes, 3 to 5 days a week.

And remember, the key to success is to maintain these healthy habits not just until you shed the pounds, but ideally for a lifetime.

  1. 1

    Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trend in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.

    • Article
    • Google Scholar
  2. 2

    WHO. Obesity: preventing and managing the global epidemic. WHO Technical Report Series Number 894. WHO: Geneva, 2000.

  3. 3

    James WTP, Rigby N, Leach R . The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil 2004; 11: 3–8.

    • Article
    • PubMed
    • Google Scholar
  4. 4

    Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Nonneux L . NEDCOM, the Netherlands epidemiology and demographic compression on morbidity research group. obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med 2003; 138: 24–32.

    • Article
    • PubMed
    • Google Scholar
  5. 5

    Preston HP . Deadweight? The influence of obesity on longevity. N Engl J Med 2005; 352: 1135–1137.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  6. 6

    Williamson DF, Parnuk E, Thues M, Flanders D, Byers T, Heath C . Modest intentional weight loss increases life expectancy in overweight women. Am J Epidemiol 1995; 141: 1128–1145.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  7. 7

    Lean ME, Powrie JK, Anderson AS, Garthwaite PH . Obesity, weight loss and prognosis of type 2 diabetes. Diabet Med 1990; 7: 228–233.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  8. 8

    Kopelman PG . Obesity as a medical problem. Nature 2000; 404: 635–643.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  9. 9

    Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ . Comparative risk assessment collaborative group. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–1360.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  10. 10

    Wolf HK, Tuomilehto J, Kuulasmaa K, Domarkiene S, Cepaitis Z, Molarius A et al. Blood pressure levels in the 41 populations of the WHO MONICA project. J Hum Hypertens 1997; 11: 733–742.

    • CAS
    • Article
    • Google Scholar
  11. 11

    Kastarinen MJ, Nissinen AM, Vartiainen EA, Jousilahti PJ, Korhonen HJ, Puska PM et al. Blood pressure levels and obesity trends in hypertensive and normotensive Finnish population from 1982 to 1997. J Hypertens 2000; 18: 255–262.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  12. 12

    Appel LJ, Moore TG, Obarzanek R, Vollmer WM, Svetkey LP, Sacks FM et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. A clinical trial of effects of dietary patterns on blood pressure. N Engl J Med 1997; 336: 117–124.

    • Article
    • Google Scholar
  13. 13

    Wannamethee SG, Shaper AG, Durrington PN, Perry IJ . Hypertension, serum insulin, obesity and the metabolic syndrome. J Hum Hypertens 1998; 12: 735–741.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  14. 14

    Hu FB, Manson JE, Stampfer MJ, Colditz J, Liu S, Solomon CG et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345: 790–797.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  15. 15

    Hu G, Lindstrom J, Valle TT, Eriksson GJ, Jousilahti P, Silventoinen K et al. Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation. Arch Intern Med 2004; 164: 892–896.

    • Article
    • PubMed
    • Google Scholar
  16. 16

    Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB . Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med 2003; 139: 161–168.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  17. 17

    Pinnock CB, Stapleton AM, Marshall VR . Erectile dysfunction in the community: a prevalence study. Med J Aust 1999; 171: 353–357.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  18. 18

    Chung WS, Sohn JH, Park YY . Is obesity an underlying factor in erectile dysfunction? Eur Urol 1999; 36: 68–70.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  19. 19

    Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo . Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000; 30: 328–338.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  20. 20

    Fung MM, Bettencourt R, Barrett-Connor H . Heart disease risk factors predict erectile dysfunction 25 years later. J Am Coll Cardiol 2004; 43: 1405–1411.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  21. 21

    Esposito K, Giugliano F, De Sio M, Carleo D, Di Palo C, D’Armineto M et al. Dietary factors in erectile dysfunction. Int J Impot Res 2006; 18: 370–374.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  22. 22

    Esposito K, Giugliano D . The metabolic syndrome and inflammation: association or causation? Nutr Metab Cardiovasc Dis 2004; 14: 228–232.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  23. 23

    Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA 2003; 289: 1799–1804.

    • CAS
    • Article
    • Google Scholar
  24. 24

    Bonetti PO, Lerman LO, Lerman A . Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 2003; 23: 168–175.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  25. 25

    Cheitlin MD . Erectile dysfunction. The earliest sign of generalized vascular disease? J Am Coll Cardiol 2004; 43: 185–186.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  26. 26

    Blumentals WA, Gomez-Caminero A, Joo S, Vannapagari V . Should erectile dysfunction be considered as a marker for acute myocardial infarction? Int J Imp Res 2004; 16: 350–353.

    • CAS
    • Article
    • Google Scholar
  27. 27

    Giugliano F, Esposito K, Di Palo C, Ciotola M, Giugliano G, Marfella R et al. Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokines levels in obese men. J Endocrinol Invest 2004; 27: 665–669.

    • CAS
    • Article
    • Google Scholar
  28. 28

    Diamant M, Tushuizen ME, Sturk A, Nieuwland R . Cellular microparticles: new players in the field of vascular disease. Eur J Clin Invest 2004; 34: 392–401.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  29. 29

    Ferreira AC, Peter AA, Mendez AJ, Jiemenez JJ, Mauro LM, Chirinos JA et al. Postprandial hypertriglyceridemia increases circulating levels of endothelial cell microparticles. Circulation 2004; 110: 3599–3603.

    • Article
    • PubMed
    • Google Scholar
  30. 30

    Sabatier F, Darmon P, Hugel B, Combes V, Sanmarco M, Velut JG et al. Type 1 and type 2 diabetic patients display different patterns of cellular microparticles. Diabetes 2002; 51: 2840–2845.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  31. 31

    Bernal-Mizrachi L, Jy W, Fierro C, Macdonough R, Velazques HA, Purow J et al. Endothelial microparticles correlate with high-risk angiographic lesions in acute syndrome. Int J Cardiol 2004; 97: 439–446.

    • Article
    • Google Scholar
  32. 32

    Koga H, Sugiyama S, Kugiyama K, Watanabe K, Fukushima H, Tanaka T et al. Elevated levels of VE-Cadherin-positive endothelial microparticles in patients with type 2 diabetes mellitus and coronary artery disease. J Am Coll Cardiol 2005; 45: 1622–1630.

    • CAS
    • Article
    • Google Scholar
  33. 33

    Werner N, Wassmann S, Ahlers P, Kosiol S, Nickening G . Circulating CD31+/Annessin V+ apoptotic microparticles correlate with coronary endothelial function in patients with coronary artery disease. Arterioscler Thromb Vasc Biol 2006; 26: 112–116.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  34. 34

    Boulanger CM, Scoazec A, Ebrahimian T, Henry P, Mathieu E, Tedgui A et al. Circulating microparticles from patients with myocardial infarction cause endothelial dysfunction. Circulation 2001; 104: 2649–2652.

    • CAS
    • Article
    • Google Scholar
  35. 35

    Brodsky SV, Zhang F, Nasjletti A, Goligorsky MS . Endothelium-derived microparticles impair endothelial function in vitro. Am J Physiol Circ Heart Physiol 2004; 286: H1910–H1915.

    • CAS
    • Article
    • Google Scholar
  36. 36

    Mesri M, Altieri DC . Leukocyte microparticles stimulate endothelial cells cytokine release and tissue factor induction in JNK-1 signaling pathway. J Biol Chem 1999; 274: 23111–23118.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  37. 37

    Esposito K, Ciotola M, Giugliano F, Schisano B, Improta L, Improta MR et al. Endothelial microparticles correlate with erectile dysfunction in diabetic men. Int J Impot Res 2007; 19: 161–166.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  38. 38

    Ford ES, Giles WH, Dietz WH . Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–359.

    • Article
    • Google Scholar
  39. 39

    Ford ES . Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US. Diabetes Care 2005; 28: 2745–2749.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  40. 40

    Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 2001; 285: 2486–2497.

    • Article
    • Google Scholar
  41. 41

    Esposito K, Giugliano F, Martedì E, Feola G, Marfella R, D’Armiento M et al. High proportions of erectile dysfunction in men with the metabolic syndrome. Diabetes Care 2005; 28: 1201–1203.

    • Article
    • Google Scholar
  42. 42

    Bansal TC, Guay AT, Jacobson J, Woods BO, Nesto RW . Incidence of metabolic syndrome and insulin resistance in a population with organic erectile dysfunction. J Sex Med 2005; 2: 96–103.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  43. 43

    Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A et al. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol 2006; 50: 595–604.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  44. 44

    Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al. The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: a prospective cohort study. J Clin Endocrinol Metab 2005; 90: 712–719.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  45. 45

    Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB . Low sex hormone-binding globulin, total testosterone, and symptomatic androgen defi ciency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab 2006; 91: 843–850.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  46. 46

    Braga-Basaria M, Dobs AS, Muller DC, Carducci MA, John M, Egan J et al. Metabolic syndrome in men with prostate cancer undergoing long-term androgendeprivation therapy. J Clin Oncol 2006; 24: 3979–3983.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  47. 47

    Hak AE, Witteman JC, de Jong FH, Geerlings MI, Hofman A, Pols HA . Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study. J Clin Endocrinol Metab 2002; 87: 3632–3639.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  48. 48

    Billups KL . Sexual dysfunction and cardiovascular disease: integrative concepts and strategies. Am J Cardiol 2005; 96: 57–61.

    • Article
    • Google Scholar
  49. 49

    Kaplan SA, Meehan AG, Shah A . The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol 2006; 176 (4 Part 1): 1524–1527.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  50. 50

    Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J et al. Report of international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 2000; 163: 888–893.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  51. 51

    Edwards WM, Coleman E . Defining sexual health: a descriptive overview. Arch Sex Behav 2004; 33: 189–195.

    • Article
    • Google Scholar
  52. 52

    Frank E, Anderson C, Rubinstein D . Frequency of sexual dysfunction in normal couples. N Engl J Med 1978; 299: 111–115.

    • CAS
    • Article
    • Google Scholar
  53. 53

    Laumann EO, Paik A, Rosen RC . Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281: 537–544.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  54. 54

    Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E et al. Sexual problems amomg women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Intern J Impot Res 2005; 17: 39–57.

    • CAS
    • Article
    • Google Scholar
  55. 55

    Esposito K, Giugliano D . Obesity, the metabolic syndrome, and sexual dysfunction. Int J Impot Res 2005; 17: 391–398.

    • CAS
    • Article
    • Google Scholar
  56. 56

    Kirchengast S, Hartmann B, Gruber D, Huber J . Decreased sexual interest and its relationship to body build in postmenopausal women. Maturitas 1996; 23: 63–71.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  57. 57

    Brody S . Slimness is associated with greater intercourse and lesser masturbation frequency. J Sex Marital Ther 2004; 30: 251–261.

    • Article
    • PubMed
    • Google Scholar
  58. 58

    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsign R et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marit Ther 2000; 26: 191–208.

    • CAS
    • Article
    • Google Scholar
  59. 59

    Corona G, Jannini EA, Maggi M . Inventories for male and female sexual dysfunction. Int J Impot Res 2006; 18: 236–250.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  60. 60

    Corona G, Mannucci E, Mansani R, Petrone L, Bartolini M, Giommi R et al. Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus. Eur Urol 2004; 46: 222–228.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  61. 61

    Enzlin P, Mathieu C, Van den Bruel A, Bosteels J, Vanderschueren D, Demyttenaere K . Sexual dysfunction in women with type 1 diabetes. Diabetes Care 2002; 25: 672–677.

    • Article
    • Google Scholar
  62. 62

    Duby JJ, Campbell RK, Setter SM, White JR, Rasmussen KA . Diabetic neuropathy: an intensive review. Am J Health Syst Pharm 2004; 61: 160–173.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  63. 63

    Salonia A, Lanzi R, Scavini M, Postillo M, Gatti E, Putrella G et al. Sexual function and endocrine profile in fertile women with type 1 diabetes. Diabetes Care 2006; 29: 312–316.

    • Article
    • Google Scholar
  64. 64

    Esposito K, Ciotola M, Giugliano F, Bisogni C, Schisano B, Autorino R et al. Association of body weight with sexual function in women. Int J Impot Res 2007; 19: 353–357.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  65. 65

    Basson R . Women’s sexual dysfunction: revised and expanded definitions. CMAJ 2005; 172: 1327–1333.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  66. 66

    Esposito K, Giugliano G, Scuderi N, Giugliano D . Role of adipokines in the obesity-inflammation relationship: the effect of fat removal. Plast Reconstr Surg 2006; 118: 1048–1057.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  67. 67

    Esposito K, Ciotola M, Marfella R, Di Tommaso D, Cobellis L, Giugliano D . The metabolic syndrome: a cause of sexual dysfunction in women. Int J Impot Res 2005; 17: 224–226.

    • CAS
    • Article
    • Google Scholar
  68. 68

    Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB . Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology 2000; 56: 302–306.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  69. 69

    Cheng JYW, Ng EML, Chen RYL . Physical activity and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res 2007; 19: 245–252.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  70. 70

    Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized trial. JAMA 2004; 291: 2978–2984.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  71. 71

    Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight. N Engl J Med 1999; 341: 427–434.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  72. 72

    Katzmarzyk PT, Janssen I, Ardem CI . Physical inactivity, excess adiposity and premature mortality. Obes Rev 2003; 4: 257–271.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  73. 73

    Hu G, Tuomilehto J, Silventoinen K, Barengo NC, Peltonen M, Jousilahti P . The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women. Int J Obes Relat Metab Disord 2005; 29: 894–902.

    • CAS
    • Article
    • Google Scholar
  74. 74

    Fung TT, Schulze M, Manson JE, Willett WC, Hu FB . Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med 2004; 164: 2235–2240.

    • Article
    • PubMed
    • Google Scholar
  75. 75

    Montonen J, Knekt P, Harkanen T, Jarvinen R, Heliovaara M, Aromaa A et al. Dietary patterns and the incidence of type 2 diabetes. Am J Epidemiol 2005; 161: 219–227.

    • Article
    • PubMed
    • Google Scholar

Afterward, everyone returned to the lab for comprehensive remeasurements. As expected, the control group’s numbers, including their weights and resting metabolic rates, had not budged. But neither had those of most of the exercisers. A few had dropped pounds, but about two-thirds of those in the shorter-workout group and 90 percent of those in the longer-workout group had lost less weight than would have been expected.

They had compensated for their extra calorie burn.

But not by moving less, the scientists found. Almost everyone’s activity-monitor readouts had remained steady. Instead, the exercisers were eating more, other measurements and calculations showed. The extra calories were slight — about 90 additional calories each day for the some-exercise group, and 125 a day for the most-exercise set. But this noshing was sufficient to undercut weight loss.

Interestingly, the researchers also found that those exercisers who had compensated the most and lost the least weight tended to be those who had reported at the start that they thought some good health habits gave people license for other, insalubrious ones.

“In effect, they felt that it’s O.K. to trade behaviors,” says Timothy Church, an adjunct professor at Pennington who led the new study. “It’s the ‘if I jog now, I deserve that doughnut’ idea.”

In consequence, they lost little if any weight with exercise.

But the study produced other, more encouraging data, he says. For one thing, almost everyone’s resting metabolic rates remained unchanged; slowed metabolisms would encourage pounds to creep back. And those few exercisers who avoided an extra cookie or handful of crackers did lose weight.

“There was only a small difference, over all,” between those who compensated and those who did not, Dr. Church says. “We’re talking about barely 100 calories. That’s about four bites of most food.”

So, people hoping to lose weight with exercise should pay close attention to what they eat, he says, and skip those last four bites, no matter how tempting.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *