News Roundup [abridged Versions Appear In The Paper Journal]

Obese men can regain sexual function by losing weight and exercising

BMJ 2004; 328 doi: (Published 24 June 2004) Cite this as: BMJ 2004;328:1517
  1. Scott Gottlieb
  1. New York

    Losing weight and exercising more can improve sexual function in about a third of obese men with erectile dysfunction, new research says.

    Researchers led by Dr Katherine Esposito of the Center for Obesity Management at the Department of Geriatrics and Metabolic Diseases at the Second University of Naples, Italy, looked at the impact of lifestyle changes on 110 obese men with erectile dysfunction (JAMA 2004;291:2978-84).

    Men randomly assigned to the intervention group (n=55) received detailed advice on how to achieve a loss of 10% or more in their total body weight by reducing energy intake and increasing their level of physical activity. Men in the control group were given general information about healthy food choices and exercise.

    All of the men in the trial had a body mass index greater than 30, were aged 35 to 55 years, and did not have diabetes, hypertension, or hyperlipidaemia. They also had a score on the international index of erectile function of 21 or less, which is considered the threshold for being able to have sex.

    After two years body mass index decreased more in the intervention group (from a mean of 36.9 (SD 2.5) to 31.2 (2.1)) than in the control group (from 36.4 (2.3) to 35.7 (2.5)) (P<0.001). The mean level of physical activity increased from 48 minutes per week (SD 10) to 195 (36) in the intervention group and from 51 (9) to 84 (28) in the control group (P<0.001).

    The mean score on the index of erectile function also improved in the intervention group, from 13.9 (4.0) to 17 (5.0) (P<0.001), but remained stable in the control group (from 13.5 (4.0) to 13.6 (4.1) (P=0.89)). Seventeen men in the intervention group and three in the control group (P=0.001) reported a score of 22 or higher—enough to regain sexual function.

    Multivariate analyses showed that improvements in body mass index (P=0.02), physical activity (P=0.02), and C reactive protein concentrations (P=0.03) were independently associated with improvements in erectile function score. As well as being a powerful indicator of risk, C reactive protein may directly participate in formation of lesions through leucocyte activation and endothelial dysfunction.

    The authors wrote, “The data demonstrate that lifestyle changes, including a reduced calorie diet and increased exercise, improve erectile function in obese men and resulted in about one third of men with erectile dysfunction regaining sexual function after treatment.

    “This improvement was associated with amelioration of both endothelial function and markers of systemic vascular inflammation. Interventions focused on modifiable health behaviors may represent a safe strategy to improve erectile function and reduce cardiovascular risk in obese patients.”

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