THE BLOG
07/18/2012 01:39 pm ET Updated Sep 17, 2012

How Weight Loss Can Improve Sex -- How Sex Can Interfere

Fat is not sexy.

That's the common belief in Western culture, one of those things "they say." However, we now have scientific verification of this. Research published in the scientific journal Obesity says:

"Obesity is associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Sexual quality of life is most impaired for women."

A Duke University study shows that obese people seeking to lose weight have these complaints 25 times the rate of normal-weight people. For men, the primary complaint is erectile dysfunction. For women it is the lack of sexual partners, the infrequency of sexual activity and the shame and low self-esteem associated with their obesity.

The good news is that studies show weight loss can resolve these problems! Studies published in Obesity report "strong and consistent evidence of the positive effects of weight loss on sexual functioning for men and evidence for the benefits of weight loss on sexual functioning for both men and women."

Other research shows that a majority of women who lost weight report far greater frequency and satisfaction of sexual activity and much better feelings about their attractiveness and their self-esteem. Our life and health improve in many ways with weight loss. What to do? Lose weight, of course!

There is no mystery to successful weight loss.

Anyone seeking scientifically-reliable information about weight loss and weight control finds that weight loss is guaranteed when one controls their eating and activities so that they achieve a negative energy balance. To lose weight, you need to eat fewer calories than you burn, creating "budget deficits." To avoid gaining it back, you must avoid creating "budget surpluses." My behavioral approach helps people to reprogram their habits so they can achieve this somewhat automatically. And it never fails when they do. In more than 25 years, I have never had a patient not lose weight following my protocols. However, not everyone follows them. What stands in their way?

Barriers to successful weight loss.

The Anderson Method is known for its observation that obesity is primarily the result of addictive overeating. Our success is through behavioral medicine that treats habitual overeating as an addiction. Food addiction is a tough barrier to weight loss, but it's not the only one. My method is an eclectic or multi-faceted therapeutic approach. The addictive aspect of eating is only one of the dynamics we work to change. In my last article, "Food, Sex, Obesity and Weight Loss," we looked at the connection between eating and sex as ways to enjoy pleasure. We have an undeniable need to experience pleasure. We talked about learning to control it, rather than letting it control us. Here, we'll look at some of the others barriers to weight loss related to our sexuality.

Sexual abuse and obesity.

Childhood sexual abuse has long been correlated with eating disorders like anorexia, bulimia, and binge eating. The behavior, either starvation, purging or binge eating, is a way to numb the pain of the trauma or a withholding of self-care because of the shame and low self-esteem. Also, both starvation and obesity desexualize the body, making it perhaps unappealing to predators. Becoming "big" is also a way of becoming as powerful or more powerful than those who pose a threat.

The authors of the CDC's landmark Adverse Childhood Experiences Study found a dramatic correlation of abuse with obesity. Obese women reported a rate of abuse 50 percent higher than women in general, and obese men reported abuse rates triple that of men in general.

Whether the dynamics are related to the power of size, numbing the pain or withholding of self-care, the high incidence of obesity in those who suffered sexual trauma as children is clear. Nowhere is the connection between sex and obesity more important to note. While obesity and weight loss are important issues, I think healing the trauma of abuse is the first order of business and more important to the person's well-being. If wanting to lose weight leads a person to the work to recover from their trauma, that may be the best outcome of weight loss efforts.

The body as a shield or restraint, an alternative to self-development.

In my practice, I have rarely encountered clients who are completely comfortable with their sexuality. Often times, they have never really adjusted to the challenges of being sexual, first encountered in their teens. Young girls can become painfully aware of the way men look at them as they mature. The unwelcome staring, leering, commenting and attentions can be an unrelenting and intolerable stress, especially if she is not taught a healthy way to think about it and respond. Creating a body that does not invite this sort of attention is one defense, and this often occurs on an unconscious level. She may consciously want very much to lose weight. But if she does, the attention starts, and so does the fear. Mysteriously, she "loses the motivation" to lose weight.

In other cases, both men and women may want to establish closeness with the opposite sex, but the rite of passage to intimacy can be fraught with anxiety over performance and acceptance. Obesity can be a restraint that holds us back from even attempting to cross that threshold. If we lost the weight, we'd have to run that gauntlet. If we stay overweight, we're off the hook.

Sometimes, women with strong sexual desires find that their libido and imagination are leading them to thoughts and actions that would jeopardize their marriages and stable home. Being overweight acts as a restraint that holds them back from acting on those impulses. Again, if we stay overweight, there's nothing to worry about.

In all of these cases, the solution lies in the successful completion of the developmental tasks that have been avoided. We need to develop the skills to deal with unwanted attentions and practice them. That may be assertiveness training, or it may be the pistol range. We need to stop seeking the acceptance of those who delight in withholding their acceptance of us. We need to experience the acceptance of those who are loving and accepting instead and practice tolerating the "stage fright" of the encounter until it dies out.

If we think that we'd like to "fool around" if we were 30 pounds less, and that would be ruinous, we either need to take responsibility to decide we really don't want that, or we'll be depending on the overweight body to hold us back.

Weight loss will improve your sex life, but it won't happen by accident.

If better health were not a good enough reason to lose weight, here is a one that is: a happy sex life. Life is made to be lived and enjoyed. If that's not happening, something is wrong that needs to be fixed. No one else is going to take responsibility for making that happen. If you can, whether you use my method or some other science-based approach, you have taken the first step to successful weight loss, a happier sex life, and more happiness in general.

1) Fairburn, C.G. & Brownell, K.D. (2002) Eating Disorders and Obesity, 2nd Edition.

2) British Medical Journal (15 June 2010) Sexuality and obesity, a gender perspective: results from French national random probability survey of sexual behaviours

3) Obesity (2012) doi:10.1038/oby.2012.104

4) Obesity (Silver Spring). 2006 Mar;14(3):472-9.

5) Masters, William, Johnson, Virginia and Kolodny, Robert, Human Sexuality, 4th ed. , Harper Collins, 1992

For more by William Anderson, MA, LMHC, click here.

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