Those big bellies Billups warns his patients about are especially worrisome when it comes to testosterone. Belly fat, a strong predictor of heart risk, seems to have a greater effect on the hormone than excess fat distributed in other parts of the body.
“That’s the bad actor that causes all sorts of inflammatory mediators and different substances to be emitted into the body that will lower testosterone,” says Billups, who studies the relationship between heart health and sexual dysfunction.
Losing even a little weight can improve blood vessel function (as the new study shows), but the effect of weight loss on testosterone levels may not be as rapid or as direct. Men who have persistently low testosterone levels and ED despite losing weight may need to consider testosterone gels, shots, or patches, Dr. Tamler says.
Weight loss can turn things around
Being overweight doesn’t seem to affect a man’s self-esteem as much as it does a woman’s, says Joel Block, PhD, a psychologist on Long Island who specializes in couples therapy and sex therapy. ED, on the other hand, can trigger a cycle of shame and doubt in even the most confident men.
“Once [ED] happens it becomes self-perpetuating,” says Block, an assistant clinical professor at the Albert Einstein College of Medicine, in New York City. “The more he fails, the more difficulty he has.”
Eventually, Block says, a man will begin to avoid sex. And his condition may plunge him into depression.
“Even if you have clear cut medical reasons—diabetes, obesity—when you’re having erectile dysfunction…it is depressing,” Dr. Billups says. “A lot of these men [are] down in the dumps.”
Losing weight can help with the plumbing aspect of ED, but it can also provide an ego boost that carries over into the bedroom, says Stephen Josephson, PhD, a psychologist at New York-Presbyterian Hospital.
“People need to feel good about themselves [to] overcome performance anxiety and other things in the sex arena, and sometimes it’s as simple as getting into shape,” Josephson says.
Some men who have relied on pills like Viagra or Cialis to get erections can toss them once they start exercising, eating right, and losing weight, Dr. Billups says.
These men may see their morning erections return, he adds, and their wives have been known to say they’re acting “friskier.”
“They’ll come in and tell me, ‘Wow, doc, things are really turned around,’” he says.
