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01-04-2012 | Review

A Review of the Relationships Between Extreme Obesity, Quality of Life, and Sexual Function

Authors: David B. Sarwer, Megan Lavery, Jacqueline C. Spitzer

Published in: Obesity Surgery | Issue 4/2012

Abstract

Extreme obesity is associated with significant health issues as well as substantial psychosocial burden for many individuals. Numerous studies have documented the impairments in quality of life associated with extreme obesity. Sexual behavior and functioning is an important aspect of quality of life but is frequently overlooked in research studies as well as clinical care. This paper focuses on the quality of life and sexual functioning of obese individuals with specific focus on the changes in these domains following the substantial weight losses seen after bariatric surgery.

Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents and adults, 1999–2002. JAMA. 2004;291(23):2847–50.PubMedCrossRef

American Society for Metabolic and Bariatric Surgery. Fact sheet: metabolic and bariatric surgery. Gainesville, FL. 2009.

Wadden TA, Butryn ML. Behavioral treatment of obesity. Endocrinol Metab Clin N Am. 2003;32:981–1003.CrossRef

Yanovski SZ, Yanovski JA. Obesity. N Engl J Med. 2002;346:591–602.PubMedCrossRef

Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 2005;13:639–48.PubMedCrossRef

Steinbrook R. Surgery for severe obesity. N Engl J Med. 2004;350(11):1075–9.PubMedCrossRef

Brolin RE. Bariatric surgery and long-term control of morbid obesity. JAMA. 2002;288:2793–6.PubMedCrossRef

Herpertz S, Kielmann R, Wolf AM, et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes Relat Metab Disord. 2003;27(11):1300–14.PubMedCrossRef

Wadden TA, Sarwer DB, Fabricatore AN, et al. Psychosocial and behavioral status of patients undergoing bariatric surgery: what to expect before and after surgery. Med Clin North Am. 2007;91:451–69.PubMedCrossRef

10.

van Hout GC, van Oudheusden I, van Heck GL. Psychological profile of the morbidly obese. Obes Surg. 2004;14(5):579–88.PubMedCrossRef

11.

Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52:155–165.

12.

Schok M, Greenen R, van Antwerpen T, et al. Quality of life after laparoscopic adjustable gastric banding for severe obesity: postoperative and retrospective preoperative evaluations. Obes Surg. 2000;10:502f–8f.CrossRef

13.

Kolotkin RL, Crosby RD, Pendleton R, et al. Health-related quality of life in patients seeking gastric bypass surgery vs non-treatment-seeking controls. Obes Surg. 2003;13(3):371–7.PubMedCrossRef

14.

Kolotkin RL, Crosby RD, Gress RE, et al. Health and health-related quality of life: differences between men and women who seek gastric bypass surgery. Surg Obes Relat Dis. 2008;4:651–8.PubMedCrossRef

15.

Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract. 1996;43:265–70.PubMed

16.

Heo M, Allison DB, Faith MS, et al. Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res. 2003;11:209–16.PubMedCrossRef

17.

Fabricatore AN, Wadden TA, Sarwer DB, et al. Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg. 2005;15:304–9.PubMedCrossRef

18.

Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.PubMedCrossRef

19.

Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health. 2005;27:156–64.CrossRef

20.

Tsai AG, Wadden TA, Sarwer DB, et al. Metabolic syndrome and health-related quality of life in obese individuals seeking weight reduction. Obesity. 2008;16:59–63.PubMedCrossRef

21.

Sullivan PW, Ghushchyan V, Wyatt HR, et al. Impact of cardiometabolic risk factor clusters on health-related quality of life in the U.S. Obesity. 2007;15:511–21.PubMedCrossRef

22.

Kolotkin RL, Crosby RD, Kosloski KD, et al. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9:102–11.PubMedCrossRef

23.

Sarwer DB, Wadden TA, Moore RH, et al. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis. 2010;6(6):608–14.PubMedCrossRef

24.

Dymek MP, Le Grange D, Neve K, et al. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res. 2002;10:1135–42.PubMedCrossRef

25.

Boan J, Kolotkin RL, Westman EC, McMahon RL, Grant JP. Binge eating, quality of life and physical activity improve after Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2004;14(3):341–8.PubMedCrossRef

26.

Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–44.PubMedCrossRef

27.

Pasquali R, Patton L, Gambineri A. Obesity and fertility. Curr Opin Endocrinol Diabetes Obes. 2007;14(6):482–7.PubMedCrossRef

28.

Gosman GG, Katcher HI, Legro RS. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update. 2006;12(5):585–601.PubMedCrossRef

29.

MacDonald AA, Herbison GP, Showell M, et al. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update. 2010;16(3):293–311.PubMedCrossRef

30.

Allison KC, Lavery MA, Sarwer DB. Obesity and reproductive functioning: psychiatric considerations. Primary Psychiatry. 2009;16:35–40.

31.

Sarwer DB, Allison KC, Gibbons LM, et al. Pregnancy and obesity: a review and agenda for future research. J Womens Health. 2006;15:720–33.CrossRef

32.

Leenen R, Van Der Kooy K, Seidell JC, et al. Visceral fat accumulation in relation to sex hormones in obese men and women undergoing weight loss therapy. J Clin Endocrinol Metab. 1994;78:1515–20.PubMedCrossRef

33.

Strain GW, Zumoff B, Miller LK, et al. Sex difference in the effect of obesity on 24-hour mean serum gonadotropin levels. Horm Metab Res. 2003;35:362–6.PubMedCrossRef

34.

Bernasconi D, Del Monte P, Meozzi M, et al. The impact of obesity on hormonal parameters in hirsute and nonhirsute women. Metabolism. 1996;45(1):72–5.PubMedCrossRef

35.

Lukanova A, Lundin E, Zeleniuch-Jacquotte A, et al. Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women. Eur J Endocrinol. 2004;150(2):161–71.PubMedCrossRef

36.

Bancroft J, Wu CW. Changes in erectile responsiveness during androgen replacement therapy. Arch Sexual Behav. 1983;12:59–66.CrossRef

37.

Traish AT, Park K, Dhir V, et al. Effects of castration and androgen replacement on erectile function in a rabbit model. Endocrinology. 1999;140:1861–8.PubMedCrossRef

38.

Aversa A, Isidori AM, De Martino MU, et al. Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clin Endocrinol. 2000;53:517–22.CrossRef

39.

Andersson B, Marin P, Lissner L, et al. Testosterone concentrations in women and men with NIDDM. Diabetes Care. 1994;17:405–11.PubMedCrossRef

40.

Ehrmann DA, Randall BB, Rosenfield RL, et al. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diab Care. 1999;22:141–6.CrossRef

41.

Deslypere JP, Verdonck L, Vermeulen A. Fat tissue: a steroid reservoir and site of steroid metabolism. J Clin Endocrinol Metab. 1985;61(3):564–70.PubMedCrossRef

42.

Niskanen L, Laaksonen DE, Punnonen K, et al. Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome. Diabetes Obes Metab. 2004;6(3):208–15.PubMedCrossRef

43.

Hakim LS, Goldstein I. Diabetic sexual dysfunction. Endocrinol Metab Clin North Am. 1996;25:379–94.PubMedCrossRef

44.

Schiel R, Muller UA. Prevalence of sexual disorders in a selection-free diabetic population (JEVIN). Diabetes Res Clin Pract. 1999;44:115–21.PubMedCrossRef

45.

Johannes CB, Araujo AB, Feldman HA, et al. Incidence of erectile dysfunction in men 40–69 years old: longitudinal results from the Massachusetts Male Aging Study. J Urol. 2000;163:460–3.PubMedCrossRef

46.

De Berardis G, Franciosi M, Belfiglio M, et al. Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked. Diabetes Care. 2002;25(2):284–91.PubMedCrossRef

47.

Phillips G, Tuck C, Jing TY, et al. Association of androgen and hyperestrogenemia with type 2 diabetes in Hispanic postmenopausal women. Diabetes care. 2000;23:74–9.PubMedCrossRef

48.

Longcope C, Baker R, Johnston CC. Androgen and estrogen metabolism: relationship to obesity. Metabolism. 1986;35:235–7.PubMedCrossRef

49.

Liosin LG. Special problems in treatment of hypertension in the patient with diabetes mellitus. Arch Int Med. 1984;144:1829–31.CrossRef

50.

Rendell MS, Rajfer J, Wicker MD, et al. Sildenafil for treatment of erectile dysfunction in men with diabetes. JAMA. 1999;281:421–6.PubMedCrossRef

51.

Enzlin P, Rosen R, Wiegel M, et al. Sexual dysfunction in women with type 1 diabetes: long-term findings from the DCCT/EDIC Study cohort. Diabetes Care. 2009;32(5):780–5.PubMedCrossRef

52.

Bacon CG, Mittleman MA, Kawachi I, et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med. 2003;139(3):161–8.PubMed

53.

Duncan LE, Lewis C, Jenkins P, et al. Does hypertension and its pharmacotherapy affect the quality of sexual function in women? Am J Hypertens. 2000;13(6 Pt 1):640–7.PubMedCrossRef

54.

Grimm Jr RH, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension. 1997;29(1 Pt 1):8–14.PubMed

55.

Derby CA, Mohr BA, Goldstein I, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;56:302–6.PubMedCrossRef

56.

Walczak MK, Lokhandwala N, Hodge MB, et al. Prevalence of cardiovascular risk factors in erectile dysfunction. J Gend Specif Med. 2002;5(6):19–24.PubMed

57.

Camps MA, Zervos E, Goode S, et al. Impact of bariatric surgery on body image perception and sexuality in morbidly obese patients and their partners. Obes Surg. 1996;6:356–60.PubMedCrossRef

58.

Keddie AM. Associations between severe obesity and depression: results from the National Health and Nutrition Examination Survey, 2005–2006. Prev Chronic Dis. 2011;8(3):A57.PubMed

59.

Kasen S, Cohen P, Chen H, et al. Obesity and psychopathology in women: a three decade prospective study. Int J Obes. 2008;32(3):558–66.CrossRef

60.

Onyike CU, Crum RM, Lee HB, et al. Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2003;158(12):1139–47.PubMedCrossRef

61.

Kalarchian MA, Marcus MD, Levine MD, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Psychiatry. 2007;164(2):328–34.

62.

Rizvi SJ, Kennedy SH, Ravindran LN, et al. The relationship between testosterone and sexual function in depressed and healthy men. J Sex Med. 2010;7(2):816–25.PubMedCrossRef

63.

McCabe M, Althof SE, Assalian P, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2010;7(1):327–36.PubMedCrossRef

64.

Clayton AH. Sexual dysfunction related to depression and antidepressant medications. Curr Womens Health Rep. 2010;2(3):182–7.

65.

Wiederman M. Body image and sexual functioning. In: Cash TF, Pruzinsky T, editors. Body image: a handbook of theory, research, and clinical practice. New York: Guilford; 2002. p. 287–94.

66.

Cash TF, Smolak L, editors. Body image: a handbook of theory, research and clinical practice. 2nd edition. New York: Guilford, 2011.

67.

Thompson JK, editor. Handbook of eating disorders and obesity. Hoboken: Wiley; 2004.

68.

Schwartz MB, Brownell KD. Obesity and body image. Body Image: Int J Res. 2004;1:43–56.CrossRef

69.

Sarwer DB, Thompson JK, Cash TF. Body image and obesity in adulthood. Psychiatr Clin N Am. 2005;28(1):68–87.CrossRef

70.

Wadden TA, Sarwer DB, Arnold ME, et al. Psychosocial status of severely obese patients before and after bariatric surgery. Probl Gen Surg. 2000;17:13–22.

71.

Dixon JB, Dixon ME, O’Brien PE. Body image: appearance orientation and evaluation in the severely obese. Obes Surg. 2002;12:65–71.PubMedCrossRef

72.

Matz PE, Foster GD, Faith MS, et al. Correlates of body image dissatisfaction among overweight women seeking weight loss. J Consult Clin Psychol. 2002;70:1040–4.PubMedCrossRef

73.

Dixon JB, Dixon ME, O’Brien PE. Depression in association with severe obesity: changes with weight loss. Arch Intern Med. 2003;163:2058–65.PubMedCrossRef

74.

Sarwer DB, Foster GD, Wadden TA. Treatment of obesity. I. Adult obesity. In: Thompson JK, editor. Handbook of eating disorders and obesity. Hoboken: Wiley; 2004. p. 421–42.

75.

Sarwer DB, Allison KC, Berkowitz RI. Assessment and treatment of obesity in the primary care setting. In: Haas LJ, editor. Handbook of primary-care psychology. New York: Oxford University Press; 2004. p. 435–54.

76.

Sarwer DB, Dilks RJ, Spitzer, JC. Weight loss and changes in body image. In: Cash TF, Smolak L. editors. Body image: A Handbook of science, practice and prevention. New York: Springer; 2011. p. 369–377.

77.

Bond DS, Wing RR, Vithiananthan S, et al. Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis. 2011;7:1–7.PubMedCrossRef

78.

de Zwaan M, Mitchell JE, Howell LM, et al. Characteristics of morbidly obese patients before gastric bypass surgery. Compr Psychiatry. 2003;44:428–34.PubMedCrossRef

79.

Dymek MP, le Grange D, Neven K, et al. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg. 2001;11:32–9.PubMedCrossRef

80.

Karlsson J, Sjostrom L, Sullivan M. Swedish Obese Subjects (SOS)—an intervention study of obesity: two-year follow-up of health-related quality of life (HRQOL) and eating behavior after gastric surgery for severe obesity. Int J Obes. 1998;22:113–26.CrossRef

81.

Dixon JB, Dixon ME, O’Brien PE. Pre-operative predictors of weight loss at 1-year after the lap-band surgery. Obes Surg. 2001;11:200–7.PubMedCrossRef

82.

Horchner R, Tuinebreijer W, Kelder H. Quality-of-life assessment of morbidly obese patients who have undergone a lap-band operation: 2 year follow-up study. Is the MOS SF-36 a useful instrument to measure quality of life in morbidly obese patients? Obes Surg. 2001;11(2):212–8.PubMedCrossRef

83.

Maciejewski ML, Patrick DL, Williamson DF. A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol. 2005;58(6):568–78.PubMedCrossRef

84.

Kolotkin RL, Crosby RD, Gress RE, et al. Two-year changes in health-related quality of life in gastric bypass patients compared with severely obese controls. Surg Obes Relat Dis. 2009;5:250–6.PubMedCrossRef

85.

Norman RJ, Noakes M, Wu R, et al. Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update. 2004;10(3):267–80.PubMedCrossRef

86.

Stamets K, Taylor DS, Kunselman A, et al. A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertil Steril. 2004;81(3):630–7.PubMedCrossRef

87.

Crosignani PG, Colombo M, Vegetti W, et al. Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet. Hum Reprod. 2003;18(9):1928–32.PubMedCrossRef

88.

Bastounis EA, Karayiannakis AJ, Syrigos K, et al. Sex hormone changes in morbidly obese patients after vertical banded gastroplasty. Eur Surg Res. 1998;30(1):43–7.PubMedCrossRef

89.

Kaukua J, Pekkarinen T, Sane T, et al. Sex hormones and sexual function in obese men losing weight. Obes Res. 2003;11(6):689–94.PubMedCrossRef

90.

Kraemer WJ, Volek JS, Clark KL, et al. Influence of exercise training on physiological and performance changes with weight loss in men. Med Sci Sports Exerc. 1999;31(9):1320–9.PubMedCrossRef

91.

Turcato E, Zamboni M, De Pergola G, et al. Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women. J Intern Med. 1997;241(5):363–72.PubMedCrossRef

92.

Kostis JB, Rosen RC, Brondolo E, et al. Superiority of nonpharmacological therapy compared to propranolol and placebo in men with mild hypertension: a randomized, prospective trial. Am Heart J. 1992;123:466–74.PubMedCrossRef

93.

Rosen RC, Kostis JB, Brondolo E. Nondrug treatment approaches for hypertension. Clin Geriatr Med. 1989;5:791–803.PubMed

94.

Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978–84.PubMedCrossRef

95.

Rosen RC, Riley A, Wagner G, et al. The International Index of Erectile Function (IIEF): a multi-dimensional scale for assessment of male erectile dysfunction. Urol. 1997;49:822–30.PubMedCrossRef

96.

Sarwer DB, Thompson JK, Mitchell JE, Rubin JP. Psychological Considerations of the Bariatric Surgery Patient Undergoing Body Contouring Surgery. Plastic and Reconstructive Surgery. 2008;121:423–434.

97.

American Society of Plastic Surgeons. 2011 report of the 2010 statistics. Arlington Heights: ASPS; 2011.

98.

Sarwer DB, Wadden TA, Pertschuk MJ, et al. The psychology of cosmetic surgery: a review and reconceptualization. Clin Psych Rev. 1998;18:1–22.CrossRef

99.

Basson R, Berman J, Burnett A, et al. Report of the International Consensus Development Conference on female sexual dysfunction: definitions and classification. J Urol. 2000;163:888–93.PubMedCrossRef

100.

Rosen RC, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marit Ther. 2000;26:191–208.CrossRef

Title: A Review of the Relationships Between Extreme Obesity, Quality of Life, and Sexual Function
Authors: David B. Sarwer
Megan Lavery
Jacqueline C. Spitzer
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Obesity Surgery / Issue 4/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-012-0588-1

At a glance: The STEP trials

Springer Medicine

A Review of the Relationships Between Extreme Obesity, Quality of Life, and Sexual Function

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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