A study reported in the British Medical Journal investigated the connection between body mass index, sexual activity, sexual satisfaction, unintended pregnancies, and abortions.
It’s an interesting field, because one might assume that obese people – specifically, in this context, obese women – are less likely to have a sexual partner and therefore less likely to have regular sexual experience. (The same, by the way, could well be true of obese men.)
However, interestingly enough, there is no association between sexual dysfunction and body mass index in obese women – which means that obese women appear to get as much sexual pleasure, or at least enjoy the same possibility of obtaining sexual pleasure, as non-obese women.
Yet at the same time, obese women under the age of 30 appear to be less likely to seek contraceptive advice and are in fact more likely to report an unintended pregnancy.
Now whether or not you regard pregnancy as an unwanted outcomes, the fact of the matter is that there is clearly a link between sexual behavior in women and body-mass index.
Why should that be so?
We know that obesity has many effects on health – these have been well documented over a long period of time. Hardly surprising, considering the number of good diets available to women.
But the effect of obesity on sexual health is not really very well understood at all, in women or men. For example, we know that in men obesity tends to be linked with erectile difficulties, but the evidence in relation to other sexual dysfunctions in men is not clear.
So in the absence of factual information, this study set out to establish precisely what relationship exists between obesity and sexual behavior in women, with specific reference to pregnancy and sexual dysfunction.
The results were obtained by interviewing about 5500 men and 6500 women between the ages of 18 and 69 by telephone. Although the survey was anonymous, and the interviewer did not know who they were speaking speaking to, only 75% of women approached agreed to complete the questionnaire.
The survey took into account the usual variables of age, income, education, gender, and so on, so that it was representative of the entire population (as it happens, the survey was conducted in France).
One of the most interesting findings, which perhaps is not surprising on considered reflection, is that there is a close correlation between the body-mass index of the male and female partner in a regular heterosexual relationship. 67% of obese women had a male partner who was overweight or obese.
But as already reported, obese women were 30% less likely to have a sexual partner in the last 12 months than normal weight women. They are even less likely than normal weight women to have an occasional sexual partner.
In fact, it emerged that obese and overweight men were about 30% less likely to report more than one sexual partner in the past year.
Obese women between the ages of 18 and 29 were three times more likely to report having met a sexual partner through the Internet than those with normal body mass index. And in fact the more obese a person is, the more likely they are to have met somebody through the Internet.
A lot fewer obese women considered that sexuality was important for their personal life than normal weight women.
As body-mass index increases, women tend to report that they believe sex is less and less important to personal life balance. This difference is not so marked with obese men.
But sexual dysfunction of all kinds is just as common in obese and overweight women as it is in women with a normal body-mass index.
What’s different however is sexual desire: the higher a woman’s body-mass index, the less likely she is to experience sexual desire. A very good reason, perhaps, for finding an effective diet that can help with quick weight loss and rebalancing a normal life.
And when it comes to sexuality and pregnancy, an unintended pregnancy or abortion occurs at a rate four times higher among obese women aged under 30 than it does in women with a normal body-mass index.
It matters not that once they have a sexual partner, women of all weights and sizes don’t seem to be any different from others in terms of how often they have sexual intercourse or indeed the nature of their sexual practices. (Although it’s hard to believe that there isn’t some modification to their chosen sexual positions, since some are so much easier for obese people than others).
There is, in short, a marked gender difference between men and women. While the partners for obese men and women are in actual fact often themselves overweight or obese, the link between these factors tends to be stronger in women than it does in men.
And women tend to be better at compensating for what presumably is a poor body image by downgrading the importance of sexuality in their lives. This could just reflect the fact that they find it less easy to attract a sexual partner.
What’s most interesting of all is the fact that there is an increases risk of unintended pregnancy for women who are obese or overweight. This is not a reflection of how they behave sexually, but it’s apparently due to the fact that overweight and obese women use less effective contraception.
In general it appears that this is because they don’t get help from medical professionals with contraception.
This could be a reflection of poor body image on their part or negative responses from the medical professionals. (And in fact it might be due to a reluctance to prescribe oral contraceptives to women who are obese because there might be a greater risk of cardiovascular problems.)
But it’s extraordinary that the absence of effective contraception is not compensated for by the use of an intrauterine device or effective condom use or long acting reversible contraception.