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Ask Dr. Caroline Apovian

Obesity and Sexual Desire

Q: My boyfriend is obese. He has lost his desire for sex almost completely. Is it due to the actual weight problem or to depression about being so heavy?

— Jill, Arizona

A: 

Probably both — and he's not alone. In a study conducted at Duke University's Diet and Fitness Center, up to 30 percent of the participants indicated problems with sex drive, desire, performance, or all three. (Many reported avoiding sex entirely.) Quite often, these problems can be traced to physical ailments brought on by obesity.

Conditions such as high cholesterol and insulin resistance (a marker of type 2 diabetes) can affect sexual performance, and that in turn affects desire, particularly in men. Both conditions can cause tiny arteries in the penis to constrict, particularly when fatty deposits begin to form. The likely result is impotence, or erectile dysfunction, which ultimately leads to a decreased sex drive. In addition, obese people often have an altered hormonal state, which can also dampen desire.

Psychologically speaking, your boyfriend may be suffering additionally because sexual satisfaction helps balance stress, including feelings of anger, sadness, anxiety, and loneliness. Plus, oxytocin, the hormone that promotes calmness, is released by arousal and orgasm, so he's missing out there as well. He may also be facing another huge hurdle when it comes to enjoying sex: poor body image. If he doesn't find himself to be sexually appealing, he will believe he is not, even if you tell him he is.

So how can he help himself (and you) rediscover the joy of sex? First of all, he should lose weight — even just a little. Studies show that losing just 10 pounds can stimulate sex hormones. Also, instituting dietary changes (like following a low-fat diet and eating more fruit and vegetables) that get blood sugar and cholesterol levels under control can help increase sex drive, whether he loses weight or not. One more way to reignite his fire: He needs to get moving! Physical activity that increases blood flow to the lower body also increases circulation — and sensation — to the genitals.

One last word of advice: Your boyfriend might benefit from therapy about self-esteem problems, so I suggest that he speak to his doctor about a referral. Good luck to both of you.

Learn more in the Everyday Health Diet and Nutrition Center.