Abstract
With approximately two-thirds of the United States adult population classified as overweight or obese, obesity remains a critical public health concern. Obesity not only contributes to several health complications including type 2 diabetes mellitus and cardiovascular disease, but the condition is also associated with sexual dysfunction in both women and men. Despite evidence linking obesity and its concomitant pathophysiology to sexual problems, the potential roles of psychosocial factors such as body image are understudied. This narrative review evaluates the research linkages between obesity and sexual dysfunction, with particular attention to the potential effects of body image dissatisfaction. A literature search of biomedical and psychological databases was used to identify research pertaining to obesity, sexual function, and/or body image constructs. The pathophysiological effects of obesity on sexual function are well-documented in mechanistic studies and animal trials, often with corroboration in human clinical samples. However, very few studies examine obesity, body image, and sexual function in tandem. Body image dissatisfaction appears to independently impinge upon the sexual response cycle and mental health outcomes, irrespective of body weight. While obesity is often associated with negative body image appraisal, it is unclear whether these constructs exert additive, synergistic, or antagonistic effects on sexual responsivity. Additionally, overweight/obese individuals who exhibit higher levels of body image satisfaction or self-confidence appear to be protected from the deleterious effects of obesity on sexual satisfaction, at least to some extent. Greater reliance upon conceptual/theoretical models from the body image literature may better clarify the relationships between these constructs.
Highlights
Accepted: 4 January 2022Despite educational programming on the deleterious effects of excess body weight, the prevalence of obesity in the United States remains high [1,2]
Within the study population (n = 27,449), 37.9% of men and 41.1% of women were classified as obese (BMI ≥ 30 kg/m2 ) in 2015–2016 [1]
9.7% of women and 5.6% of men were categorized as severely obese (BMI ≥ 40 kg/m2 ) [1]
Summary
Accepted: 4 January 2022Despite educational programming on the deleterious effects of excess body weight, the prevalence of obesity in the United States remains high [1,2]. Drawing upon body-mass index (BMI) data from the National Health and Nutrition Examination Survey (NHANES), Hales and colleagues noted a 5.9% increase in the age-standardized obesity prevalence among adults between the 2007–2008 and 2015–2016 interview periods [1]. Within the study population (n = 27,449), 37.9% of men and 41.1% of women were classified as obese (BMI ≥ 30 kg/m2 ) in 2015–2016 [1]. 9.7% of women and 5.6% of men were categorized as severely obese (BMI ≥ 40 kg/m2 ) [1]. Data from the 2017–2018 collection period revealed that approximately 30% of respondents were classified as overweight (BMI ≥ 25 kg/m2 ) [3]. The combined prevalence of overweight and obesity exceeds two-thirds of the adult US population.
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