Obese men are at increased risk for erectile dysfunction likely caused by atherosclerosis-related hypertension and cardiovascular disease, as well as hormonal changes associated with obesity.

"If you are looking for another reason to lose weight, research now suggests that erectile dysfunction can improve with weight loss," says James O. Hill, Editor-in-Chief of Obesity and Weight Management.

As many as 30-40% of men over the age of 50 may experience erectile dysfunction, and both obesity and physical inactivity can increase their risk. The build-up of atherosclerotic plaque in the arteries of obese men can damage the arterial lining and contribute to elevated blood pressure. In addition to atherosclerosis, the hormonal changes that accompany obesity, including lower testosterone, increase the risk of erectile dysfunction. The modifiable risk factors for heart disease, such as excess weight, diabetes, and hypertension, are generally the same as those for erectile dysfunction. Studies have shown that weight loss and increased physical activity can improve erectile dysfunction.

In one case study, a 48-year-old man with mild obesity (weight = 197 lbs, body mass index = 32.6 kg/m2 ) and hypertension who suffered from erectile dysfunction was not able to achieve an erection adequate for intercourse even with the use of erectile dysfunction medications. After dietary counseling, a 4.6% weight reduction, and lowering his blood pressure to within the normal range (112/77 mm Hg), the patient has been able to achieve adequate erections.

The study authors emphasize that "the complicated interplay of weight and other health conditions relate to common medical symptoms, such as erectile dysfunction. We are reminded that atherosclerosis can cause not only macrovascular disease such as heart attack and stroke, but also microvascular disease, of which erectile dysfunction is one example."
References:
1. Adam Gilden Tsai, David Sarwer. Obesity and Erectile Dysfunction. Obesity and Weight Management, August, 2009.