Impaired quality of life and sexual function in overweight and obese men: the European Male Ageing Study.
Han TS., Tajar A., O'Neill TW., Jiang M., Bartfai G., Boonen S., Casanueva F., Finn JD., Forti G., Giwercman A., Huhtaniemi IT., Kula K., Pendleton N., Punab M., Silman AJ., Vanderschueren D., Lean ME., Wu FC., EMAS group None.
BACKGROUND: Few published data link overweight and obesity with measures of quality of life (QoL) including sexual health in men. OBJECTIVE: To assess the association of overweight/obesity with impairment of physical and psychological QoL and sexual functions in men. DESIGN AND SETTING: Cross-sectional, multicentre survey of 3369 community-dwelling men aged 40-79 (mean±s.d., 60±11) years randomly selected from eight European centres. OUTCOMES: Adiposity was assessed by body mass index (BMI) and waist circumference (WC), QoL and functional impairments by physical and psychological function domains of the Short Form-36 questionnaire, Beck's Depression Inventory and the European Male Ageing Study sexual function questionnaire. RESULTS: Complete data on sexual activities and erectile function were available in 2734 (92%) and 3193 (95%) of the participants respectively. From the population studied, 814 men were obese (BMI ≥30 kg/m(2)) and 1171 had WC ≥102 cm, 25% of all men were unable to do vigorous activity and 2-13% reported depressive symptoms. Symptoms of sexual dysfunction ranged between 22% (low sexual desire) and 40% (infrequent morning erections) of the participants. Among obese men with both BMI ≥30 kg/m(2) and WC ≥102 cm, at least one symptom of impaired physical, psychological and sexual function was reported by 41, 43 and 73% of the participants respectively. Compared with the reference group of non-obese men (BMI <30 kg/m(2) and WC <102 cm), men with BMI ≥30 kg/m(2) and WC ≥102 cm more frequently reported at least one symptom of impaired physical function (odds ratio (OR)=2.67; confidence interval (CI): 2.07-3.45, P<0.001), impaired psychological function (OR=1.48; CI: 1.14-1.90, P<0.01) and impaired sexual function (OR=1.45; CI: 1.14-1.85, P<0.01). These functional impairments were also more prevalent in men who had WC ≥102 cm even with BMI <30 kg/m(2), but those with BMI ≥30 kg/m(2) and WC <102 cm generally did not suffer from increased impaired physical or sexual health. Men with high BMI and WC were at even greater likelihood of having a composite of two or more or three or more symptoms compared with those with normal BMI and WC. CONCLUSIONS: Men with high WC, including those who are 'non-obese' with BMI <30 kg/m(2), have poor QoL with symptoms of impaired physical, psychological and sexual functions. Health promotion to improve QoL should focus on prevention of obesity and central fat accumulation.