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Diet and Exercise Programs Have Benefits for Obese Men With Erectile Dysfunction

A program that reduced dietary calories and increased exercise improved erectile function in obese men and resulted in about one third of men regaining sexual function, according to the findings of a randomised, single-blind trial.

"This study provides evidence that weight loss achieved by lifestyle changes can ameliorate erectile function in obese men with erectile dysfunction at baseline," reports Katherine Esposito, MD, Center for Obesity Management, Department of Geriatrics and Metabolic Diseases, Policlinco Universitario, Naples, Italy, and colleagues.

Researchers randomly assigned 55 men with a mean age of 43 years, mean weight of 101 kg, and mean body mass index (BMI) of 36.4 to receive information about healthy food choices and exercise. A second group of 55 men with a mean age of 43.5 years, mean weight of 103 kg, and mean BMI of 36.9, comprised the intervention group that received instruction on reducing caloric intake, setting goals, and self-monitoring food diaries; behavioural and psychological counselling, and guidance on increasing physical activity through walking, swimming, and aerobic games.

The groups had no evidence of diabetes, hypertension, or hyperlipidemia at baseline, and had not participated in a diet reduction program within the previous 6 months.

After 2 years, the intervention group had a mean weight loss of 15 kg, and a mean reduction in BMI of 5.7, compared with 2 kg mean weight loss, and a mean reduction in BMI of 0.7 in the control group. The level of physical activity increased from 48 min/week to 195 min/week in the intervention group, compared with a change from 51 min/week to 84 min/week in the control group.

The intervention group had greater decreases in serum concentrations of interleukin 6 and C-reactive protein than did the control group. The intervention group also had significant decreases in waist-to-hip ratio, blood pressure, and levels of glucose, insulin, total cholesterol and triglycerides, as well as significant increases in high-density lipoprotein cholesterol. The control group did not show significant changes in these values.

Scores on the International Index of Erectile Function (IIEF) improved from 13.9 at baseline to 17 at 2 years in the intervention group compared with 13.5 to 13.6 from baseline to 2 years in the control group. A total of 17 men in the intervention group and 3 in the control group reported IIEF scores of 22 or higher.

Multivariate analyses revealed that changes in BMI (P = .02), physical activity (P = .02), and C-reactive protein levels (P = .03) were independently associated with changes in the IIEF score.

"Interventions focused on modifiable health behaviours may represent a safe strategy to improve erectile function and reduce cardiovascular risk in obese patients," the authors conclude.


JAMA 2004;291:2978-2984

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