Obesity is one of most prevalent health problems of our times, and a greater proportion of men than women are classified as overweight or obese. According to the latest government data, 63.8 per cent of adults in England are overweight or obese, and the gender divide is 58.4 per cent of women and 69.1 per cent of men.
Obesity is most prevalent in adults between the ages of 45 and 84 years, and it is associated with reduced life expectancy and a range of chronic diseases. For example, there is a clear correlation with obesity and heart disease, type 2 diabetes, liver disease, 12 types of cancer, and respiratory disease.
Being overweight or obese can also cause worse mental health outcomes, including depression, anxiety, and low self-esteem. For men, it can also cause erectile dysfunction (ED), which is defined as the inability to get or maintain an erection long enough for a satisfactory sexual experience.
The link between ED and obesity is not always openly discussed, and this can mean that some men may be suffering in silence because of a lack of awareness, or embarrassment about discussing a sensitive personal issue with a medical professional.
The exact cause of obesity-related ED can be difficult to pinpoint, because ED is also closely related to other health issues caused by obesity. These include hypertension, diabetes, cardiovascular disease, and mental health problems such as depression and anxiety.
However, it is known that males carrying excess weight have lower testosterone levels, which can affect sex drive and sexual function. It also damages the lining of the blood vessels, and this means that they can’t dilate normally to allow an erection to happen.
Fortunately, there are safe and effective treatments for ED, including sildenafil (the trade name for Viagra), which works by increasing the flow of blood to the penis. This is usually offered as the first line of medical treatment, and is effective for around 80 per cent of men.
However, it is important to treat the underlying causes of ED and not just the problem itself. Overweight men are often advised to make lifestyle changes, such as eating a healthier diet, taking more exercise, cutting back on alcohol, and getting more sleep.
These measures sound straightforward on paper, but in reality they can take a lot of time and willpower. Often, a sedentary lifestyle and a high-fat diet are the result of a lifetime’s ingrained habits, and some men may find that these patterns of behaviour are difficult to break, or they do not have the inclination or motivation to do so.
The introduction of weight loss drugs such as Wegovy may offer a way forward for some men, but presently it has very limited availability in the UK. It is also known to cause side effects, and ironically these can include ED.
However, there may be some new thinking on the complex issue that could make a difference. A major new study led by researchers at the University of Stirling has found that offering men financial incentives to lose weight is effective.
The study involved 585 men living with obesity across the UK. They were divided into three groups: the first was offered cash incentives of £400 for meeting their weight loss goals, the second was sent supportive text messages, and the third received no support or incentives.
At the end of the 12-month study, the men who were offered cash incentives were found to have lost the most weight.
Professor Pat Hoddinott, of the Nursing, Midwifery and Allied Health Professions Research Unit at the University of Stirling, who led the study, said:
“Losing weight can make people feel better, reduce their risk of many health problems such as diabetes, and helps the health service with their aim to keep men well. However, we know men often don’t like to go to traditional weight loss groups.”
“This was a very carefully planned study, created for men with men. We worked closely with various men’s health groups and charities, including Men’s Health Forum in the UK and Ireland, with more than 1000 men living with obesity informing the design of the incentive structure.”
At first glance, paying men to lose weight might not appear to be cost-effective for the health service. However, when measured against future savings for treating potentially much more serious diseases as the men age, it could prove to be a good investment.
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