Introduction
Obese or overweight men are more likely to suffer from ED. Here’s what you can do to lose weight and improve your sexual performance.
You might know that being overweight or obese ramps up the risk of a lot of different diseases including heart disease, diabetes, high blood pressure, obstructive sleep apnea, cancer, osteoarthritis—even depression. But did you know it can also increase the risk of erectile dysfunction (ED), the inability to achieve erections or to stay hard long enough for sex?
Compared with men who are normal weight, men who are overweight or obese have a 30%-90% increased risk of ED. Men who have erectile dysfunction tend to be heavier and have a larger waist compared to men without ED.
Can Being Overweight Cause ED?
Packing on the pounds can lead to erectile dysfunction in a number of ways. Belly fat can lead to inflammation, which in turn contributes to what scientists call endothelial dysfunction. This is when the inner lining of blood vessels (the endothelium) becomes damaged, interfering with healthy blood volume throughout the body, including to the penis.
This endothelial dysfunction leads to a whole host of problems and the development of many of the diseases that are linked to both obesity and erectile dysfunction. By causing these diseases, obesity and being overweight can interfere with erectile function, not to mention lead to life-threatening complications.
Risk of ED for Different BMI Ranges
Cardiovascular Disease Risk Factors
Excess body fat is a major risk factor for cardiovascular diseases. Obesity and overweight are linked to coronary artery disease risk factors such as high blood pressure and high blood sugar.
The more obese a person is, the greater their chance of developing cardiovascular disease, but even being slightly obese can start a string of events that leads to the development of heart problems. On the other hand, losing weight can lead to improvements in heart health.
Erectile dysfunction and vascular disease share the same risk factors, so anything that ramps up the risk of cardiac problems—like obesity—can also lead to sexual dysfunction. ED often occurs before the development of heart problems and can even predict whether a man develops cardiovascular problems.
Metabolic Syndrome and Erectile Dysfunction
Cardiac disease often begins as metabolic syndrome, a cluster of risk factors for heart disease that include high blood sugar, belly fat, high blood pressure, and high cholesterol. Obesity and being overweight, especially visceral fat, are strongly linked to metabolic syndrome.
Scientists now believe that metabolic syndrome may be a risk factor for erectile dysfunction. Men with erectile dysfunction are more likely to have metabolic syndrome compared with men who don’t have ED.
Diabetes
Having a high body mass index can wreak havoc on blood sugar, leading to diabetes. Both type 1 and type 2 diabetes increase the risk of erectile dysfunction.
Men with diabetes are more likely to have erectile dysfunction than men without diabetes. It’s estimated that 35%-75% of male diabetics have erectile dysfunction and that ED develops 10-15 years earlier in men with diabetes compared to non-diabetic men.
Even if a man doesn’t have full-blown diabetes, weight gain can lead to prediabetes, a condition where blood sugar is higher than normal but not high enough to fall into the diabetes category. Especially in men younger than 50 years old, prediabetes is a risk factor for sexual dysfunction.
Men with diabetes or prediabetes often have metabolic syndrome, a condition addressed in more detail earlier in this article. Metabolic syndrome is another way that packing on the excess pounds is connected to erectile dysfunction.
High Blood Pressure
The damage to the inner lining of blood vessels that happens in obese men can cause a lot of problems, including high blood pressure. Hypertension in and of itself is linked to erectile dysfunction. But some of the drugs used to treat hypertension can actually cause erectile dysfunction, too.
The biggest culprit is a class of drugs known as beta-blockers, which interfere with erectile function. The one exception is the beta-blocker nebivolol, which increases levels of erection-enhancing nitric oxide and therefore improves erectile function.
Low Testosterone Levels
Men who need to lose weight often have low testosterone levels, a hormone linked to a healthy sex life, sexual desire, and sexual performance. Men who have low testosterone levels are more likely to have increased fat mass, especially belly fat.
If that’s not enough to establish a connection between low testosterone levels and body fat, there’s the fact that weight loss boosts testosterone levels in many overweight men. Talk to your doctor about ways to increase testosterone production, including testosterone replacement therapy.
High Cholesterol
High cholesterol causes atherosclerosis, a narrowing of the blood vessels. Cholesterol builds up in the vessels, which reduces blood flow throughout the body, including to the penis.
Obesity and being overweight promote inflammation and endothelial dysfunction that can lead to atherosclerosis, which in turn leads to erectile dysfunction by interfering with healthy blood flow, the most common cause of ED.
Sleep Apnea
Obstructive sleep apnea, a condition where a person stops breathing briefly in their sleep, often goes hand in hand with obesity. In this type of sleep apnea, called OSA for short, the throat muscles relax from time to time during sleep. This blocks the airway, causing a person to temporarily stop breathing.
At least 60%-70% of people with obstructive sleep apnea are obese. Due to the connection between sleep apnea and obesity, doctors often recommend that patients with sleep apnea lose weight.
Sleep apnea takes its toll on the sexual health of men. One study found that 55% of men attending an andrology outpatient clinic with a new diagnosis of erectile dysfunction showed evidence of having OSA. These men also had worse International Index of Erectile Function (IIEF) scores compared to men who didn’t have OSA.
Other Reasons Why Obesity Is Linked to ED
In addition to a direct connection between obesity and erectile dysfunction, being overweight or obese can indirectly cause erectile dysfunction, too. Obesity affects not only physical health, but it’s also one of a number of psychological factors linked to ED. Many men who are insecure about their body image have poor self esteem that can lead to sexual performance anxiety.
Obesity and overweight also are associated with bad habits that don’t do much for a healthy sex drive. Obese men are often more sedentary and don’t participate in the physical activity needed to maintain sexual health.
Eating an unhealthy diet is another common bad habit among people who are overweight or obese. Poor diets are linked to reduced blood flow throughout the body and the penis.
How To Get Rid of ED in Overweight and Obese Men
The best way for men to improve their sexual health is to shed some body weight. This is the only ED treatment some men need. Here are some ways to leave behind the excess fat.
Losing Weight
The following are several effective methods for dropping pounds. Joining a weight loss support group is a great way to keep yourself motivated as you embark on a weight loss program that includes any of the below strategies.
Eating Healthy
One of the best ways to lose weight while at the same time reducing your risk of cardiovascular disease and erectile dysfunction is to eat a diet rich in fruits and vegetables, whole grains, legumes, nuts, seeds, and olive oil along with some fish and chicken. This type of healthy diet, in which people only rarely eat red meat and sugary desserts, is known as the Mediterranean diet.
The Mediterranean diet is best known for reducing heart disease. In men with erectile dysfunction, it also improves ED by increasing levels of nitric oxide, a chemical produced in the body that improves blood flow and triggers healthy erections.
The Mediterranean diet also may reduce cholesterol and help the body make better use of blood sugar, two health benefits good for the heart and for sexual function.
Intermittent Fasting
Weight loss is not only about what a man eats, but also when he eats it. Men who participate in what’s called intermittent fasting have a reduced risk of erectile dysfunction. Most people on this type of eating pattern eat only in a 6-8 hour window and fast for the remaining 16-18 hours per day. As an alternative, some people participating in intermittent fasting go for 24 hours without eating a couple days a week.
Intermittent fasting can improve some of the risk factors for erectile dysfunction in overweight and obese men. It leads to weight loss and reduces abdominal fat in obese people with type 2 diabetes.
Intermittent fasting is a good option for losing weight since it leads to other beneficial effects on cells and reduces insulin resistance, a harmful process where the body starts to ignore insulin’s blood-sugar-lowering signals. It’s best to talk to your healthcare provider before embarking on this type of diet, especially if you have any health issues.
Get Moving
Being a couch potato is not good for your sex life or weight loss. Increasing physical activity by starting an exercise program can help lose fat, improve cardiovascular health, and lead to normal erectile function. To improve erectile dysfunction the best bet is moderate-to-vigorous aerobic exercise.
Bariatric Surgery
Sometimes increasing physical activity and eating a healthy diet doesn’t lead to enough weight loss. In this case, men may turn to bariatric surgery.
Doctors usually only recommend bariatric surgery—otherwise known as gastric bypass surgery—for the severely obese or who are obese with major weight-related health issues. In research using animals with type 2 diabetes mellitus, bariatric surgery improved ED by improving the corpus cavernosum, spongy tissue along the shaft of the penis that plays an important role in erections.
If you think this may be an option for you, talk to your doctor about this type of surgery.
ED Medications for Sleep Apnea
Men whose erectile dysfunction is caused by sleep apnea can talk to their doctor about ED pills like sildenafil. Research has shown that sildenafil was more effective in treating ED related to obstructive sleep apnea compared with continuous positive airway pressure (CPAP) devices.
Men with sleep apnea taking sildenafil were more likely to have successful attempts at intercourse and better erectile function. The sexual satisfaction rate in men taking sildenafil was 68%. In men using CPAP it was only 29%.
