TY - JOUR AU - Kałka, Dariusz AB - BackgroundImpaired sexual functioning is one of the consequences of obesity with hormonal disorders involving testosterone.AimTo explore the link between obesity and sexual desire, to assess how changes in body weight affect sexual desire, and to examine the role of testosterone in these changes in obese and overweight men.MethodsThe systematic review was conducted in PubMed. Studies involving obese/overweight men that reported different libido levels or changes after weight loss interventions were included. Meta-analysis and meta-regression were performed.ResultsThe search identified 2259 studies, of which 28 met the eligibility criteria. Most studies focused on weight-loss interventions (n = 21, 77%), with 13 studies investigating the effect of bariatric surgeries. Testosterone levels were reported in 14 studies. The studies encompassed a total population of 18 653 people, including 10 356 obese and overweight men. Of the 28 identified studies, 15 indicated a potential association between BMI, waist circumference, and sexual desire. Effect size meta-analysis (calculated using data from four studies presenting results before and after bariatric surgery) suggests that an increase in the International Index of Erectile Function sexual desire domain was very strongly associated with changes in a patients’ weight resulting from bariatric surgery (d = 1.22, 95% CI 0.41-2.03, P = 0.003). The meta-analysis of four studies, presenting results before and after diet intervention, showed a strong impact of weight loss on an increase of the Sexual Desire Inventory (SDI), (d = 1.16, 95% CI 0.44-1.88, P = 0.002) The meta-regression revealed a significant association between the level of sexual desire on the SDI and the magnitude of BMI changes before and after dieting interventions (R2 = 77.97%; P = 0.002). The meta-analysis of plasma total testosterone levels from studies that present results before and after selected diets showed a strong impact of diet on the increase in testosterone levels after interventions (d = 1.39 95% CI 0.86-1.92; P < 0.001). There was a significant impact of the level of plasma total testosterone on the variance of sexual desire in the SDI questionnaire (R2 = 5.33%; P < 0.001).Limitations of evidenceA lack of studies that focus on sexual desire in obesity, the heterogeneity of the included population, the variability in the used questionnaires and reported statistics.ConclusionsA potential association between sexual desire and body weight exists. Weight loss interventions, including dietary changes and bariatric surgery, significantly increased both sexual desire and plasma total testosterone levels. Additionally, variations in plasma total testosterone levels had a significant effect on the variability of sexual desire in obese men. TI - Obesity and sexual desire: a systematic review and meta-analysis JO - The Journal of Sexual Medicine DO - 10.1093/jsxmed/qdaf057 DA - 2025-03-31 UR - https://www.deepdyve.com/lp/oxford-university-press/obesity-and-sexual-desire-a-systematic-review-and-meta-analysis-vpKsr0WJkc SP - 677 EP - 693 VL - 22 IS - 5 DP - DeepDyve ER -