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Lifestyle Changes Improve Erectile Dysfunction

Obese men with erectile dysfunction benefited from a nonpharmacologic intervention.

Obese men have increased risk for erectile dysfunction compared with normal-weight men. Researchers in Italy studied the effects of a lifestyle intervention in 110 obese men (body-mass index, 30 kg/m²; age range, 35-55) with low scores for erectile function on a standard questionnaire. None had diabetes, hypertension, or hyperlipidemia. Subjects were randomized to receive either general lifestyle information (control) or an intervention involving caloric and activity goals, counseling, and about 18 sessions with a dietician and trainer during 2 years.

At 2 years, the intervention group -- but not the controls -- showed significant improvements in mean BMI (from 37 to 31), interleukin-6 levels, and C-reactive protein (CRP) levels. Mean physical activity levels increased significantly more in the intervention group (from 48 to 195 minutes weekly) than in the control group (from 51 to 84 minutes weekly), although both changes from baseline were significant. The mean erectile function score improved significantly more in the intervention group than in the control group, and significantly more intervention recipients than controls achieved normal function (31% vs. 5%). In a multivariate analysis, improvements in BMI, physical activity, and CRP levels each were associated independently with improved erectile function.

Comment: These findings show promise for lifestyle-based interventions for erectile dysfunction in some obese men and suggest that endothelial dysfunction contributes to the condition. However, an editorialist notes that this intervention currently is not reproducible in primary care settings and that these subjects, who lacked metabolic syndrome characteristics, aren't representative of many obese primary care patients. These data should be replicated in other clinical settings.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine July 6, 2004

Citation(s):

Esposito K et al. Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA 2004 Jun 23/30; 291:2978-84.

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Saigal CS. Obesity and erectile dysfunction: Common problems, common solution? JAMA 2004 Jun 23/30; 291:3011-2.

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• Medline abstract (Free)