Less Food, More Amore

Lifestyle changes may help combat impotence in overweight men

For men hoping to improve their love lives, staying out of the refrigerator may be the best line of defense.

A study published in the Journal of the American Medical Association found that obese men suffering from impotence can increase sexual performance through such lifestyle changes as diet and exercise.

Italian researchers from the Center for Obesity Management at the Second University of Naples examined 110 men, 35 to 55 years old, who had erectile dysfunction. Each participant was considered obese, with a body mass index of 30 or higher. Half were counseled on exercise plans and weight-loss goals, and the others were given just general information about healthy food choices and exercise.

About a third of the men who were counseled about a healthy regimen were able to consistently achieve an erection. Only five of the men (9 percent) who had not received lifestyle counseling reported improved sexual performance.

American experts, however, disagree in their interpretation of the study's finding.

"The benefits of lifestyle changes are so strong that I would use them as a first-line treatment, with pharmacological intervention as a second line," Dr. Christopher Saigal, an assistant professor of medicine at the University of California , Los Angeles , told HealthDay .

But Dr. Andrew McCullough, director of male sexual health, fertility and microsurgery at New York University Medical Center , said he would prescribe a drug in most cases, even while advising men to exercise more and eat less.

Though McCullough conceded the study showed that lifestyle changes can improve sexual performance for obese men, he expressed reservations because the benefits took more that two years to take hold.

"Two years for improvement requires a lot of sacrifice," McCullough told HealthDay . "I would not withhold a drug from these men."

Both doctors agreed that weight loss and physical activity offer clear benefits for overall health. But they said other factors such as diabetes, high blood pressure or high cholesterol can have major effects on health and sexual performance.

They noted that no men with these conditions were included in the study.

"The presence of these comorbid conditions may lessen the impact of exercise and weight loss on erectile dysfunction," Saigal wrote in an editorial that appeared in the same issue of the journal. Another caveat could be problems with follow through, as "counseling overweight patients to begin and sustain effective weight-reducing behaviors can be a daunting challenge for clinicians," he said.

But, Saigal admitted, sexual performance is critical to most men and a desire for improvement would make them more likely to follow lifestyle advice.

"I would tell them to take weight loss seriously," he said. "If it doesn't work, at least it doesn't hurt them."

Of course, McCullough noted, drug therapy and lifestyle changes are not mutually exclusive.