When BMI blocks your love life

Just shedding 5% of weight could lead to a 16% improvement from erectile dysfunction problems, according to a year-long study carried out at Changi General Hospital.

Check your weight, guys, if you're looking to improve your sex lives! One would think it's a no-brainer, but not many guys actually realise that among the benefits of losing weight would be improved libido.

But just shedding 5 per cent of weight could lead to a 16 per cent improvement from erectile dysfunction problems, according to a year-long study carried out at Changi General Hospital (CGH) from June 2010 to July 2011.

This is the first local study of its kind - to assess the effectiveness of weight loss through lifestyle modification for tackling erectile dysfunction and urinary tract problems in men who are obese.

"We hope that this will increase awareness of the link between obesity and these problems," says Joan Khoo, director of the hospital's Diabetes Centre and consultant endocrinologist.

Thirty to 70 per cent of obese men have erectile dysfunction. That's because obesity and increased visceral fat can lead to worsened insulin production, diabetes, and this causes poor blood circulation and inflammation, which in turn leads to poor circulation in the penis.

"Erectile dysfunction is a precursor to ischaemic heart disease and blockage of heart vessels," says Dr Khoo.

Men who have erectile dysfunction are likely to develop cardiovascular disease, especially if they have risk factors like diabetes and hypertension. Lower urinary tract problems like frequency of urination, difficulty in positioning, draining when urinating, and urinating at night are associated with obesity. Although the prevalence varies, it definitely increases with BMI and age. "There's a direct correlation between BMI and weight, but the thing is, some men don't even know the two are inter-related until they see a doctor," Dr Khoo says.

Forty-five Singaporean men, aged between 30 to 65, were recruited for the study. They all had a BMI of more than 27.5 kg/m2 and waistlines of more than 90cm - which defined them as obese. They were then put on an exercise-and-diet regime for 24 weeks, with advice on reducing caloric intake and five sessions of physical activity each week, averaging 30 to 60 minutes each time. The men were motivated to lose weight, says Dr Khoo. Which means compliance was high as well, with 85 per cent of men completing the 24-week study.

After 12 weeks, the men showed a mean weight loss of 5kg, about 5 per cent from the baseline and a mean reduction of the waist circumference of four cm, or 4 per cent. Meanwhile, the erectile dysfunction score showed a 2.6 point improvement, which is a 16 per cent increase from the baseline.

There was also improvement in lower urinary tract functions by 20 per cent, and an increase of testosterone levels by 20 per cent. "Testosterone levels naturally increase with the weight loss. When there is increased visceral abdominal fat, this gets converted into the female hormone oestrogen. Which is why when men lose fat, their testosterone goes up," explains Dr Khoo.

Quality of life improvement was 12 per cent. Preliminary findings after 12 weeks have been presented at this year's European Congress of Obesity.

"The results were quite good, given that a similar study in Australian showed that Australian men needed a weight loss of 5 to 10 per cent in order to see similar improvements," says Dr Khoo.

The reason for the study is to quantify the benefits that weight management can bring. "We saw patients coming for weight management and the benefits that they experienced. When we brought up erectile dysfunction and urinary tract issues, the men weren't aware of it and asked for data. So we decided to do this study to motivate them," explains Dr Khoo.

CGH has a Weight Management Programme to address obesity, which is a major cause of diabetes. "If you treat one, you treat the other. If weight is reduced, it reduces the risk of diabetes. Erectile dysfunction is also related to diabetes and obesity. It's inextricably linked and it's the fastest way to motivate overweight men because the message hits home," she concludes.



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