The mechanisms linking obesity to erectile dysfunction are multifactorial: Endothelial dysfunction : Excess adipose tissue promotes inflammation and impairs the function of blood vessel linings, reducing blood flow to the penis Hormonal imbalances : Obesity is associated with reduced testosterone levels and increased oestrogen, which can negatively impact sexual function Cardiovascular disease : Obesity increases the risk of atherosclerosis, hypertension, and other vascular conditions that compromise erectile function Metabolic syndrome : The cluster of conditions including insulin resistance, dyslipidaemia, and hypertension associated with obesity all contribute to erectile difficulties Psychological factors : Body image concerns, depression, and reduced self-esteem related to obesity can affect sexual confidence and performance Weight loss has been shown to improve erectile function in numerous studies

9 These diabetes medicines are potentially underused in patients who would benefit from them
Weight maintenance patients, metabolic optimization patients at a healthy weight, first-time GLP-1 patients sensitive to side effects, and patients managing PCOS, insulin resistance, or hormone transitions
Smaller portions, lower calorie intake, different choices