- Physical barriers – The larger size and shape of partners bodies can make certain positions more difficult or challenging and can be a deterrent to intimacy. While some positions might be impossible, couples should not lose hope, instead keep trying new possibilities. Also physical size can limit stamina.
- Health issues and medications– Common comorbidities to obesity such as diabetes, heart disease, cancer, hypertension, depression, dementia and other ailments can affect sexual function. Also medications used to treat those condition can cause sexual dysfunction.
- Hormone imbalance – Excess fat can lead to changes in hormone levels. Decreased testosterone levels in men can cause erectile dysfunction. In women, changes in estrogen levels affects their menstrual cycle and fertility.
- Body image – Excess weight and excess skin after losing weight can cause individuals to have negative body image and not feel comfortable with their partners seeing them without clothes.
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