For cultural reasons, many Jamaicans still associate obesity with good health and sex appeal. These beliefs are false. It has been very well established that obesity puts the individual at increased risk of a long list of diseases. One medical journal listed 130 disorders connected to excess body fat. Authorities now consider obesity to have replaced cigarette smoking as the commonest preventable cause of death.

Less publicity, however, has been given to the fact that excess fat can also interfere with your sex life. Researchers at Duke University's Diet and Fitness Center in the United States reported that, in many areas of their sex lives, the obese report 25 times as many problems as people of normal weight. Both men and women complained of lack of sexual desire and enjoyment, along with poor performance. In fact, many fat people reported avoiding sex completely.

But let me provide some consolation to our ladies - the location of your excess fat is important. Truncal or abdominal obesity creates the most problems. Often called apple-shaped obesity in distinction to pear-shaped, the truth is that it is "fat around our waist that will shorten your life in a haste". Research shows that a waist measurement of more than 39 inches in men and more than 34 inches in women will increase your risk of these problems by a whopping 500 per cent. The fat around the hips and buttocks is not considered hazardous to your health.

Let's look at some reasons why obesity may compromise sexual function:

HEALTH PROBLEMS

The obese are at increased risk of many diseases and, in general, the poorer your health the worse your sex life. This is especially true for illnesses involving the heart and circulation as good blood flow is a major requirement for good sex (Viagra improves erections by chemically increasing blood flow).

Even when you have not been formally diagnosed with heart disease, hypertension, diabetes or abnormal blood lipids, if you are obese, it is highly probable that your circulatory system is already compromised. In addition to poor blood flow, diabetics also suffer from damage to nerve endings and a decreased responsiveness to sexual stimulation. Sadly, the obesity epidemic has brought with it the diabesity epidemic.

If that were not enough, many of the drugs used to treat these diseases further impair sexual function.

DECREASED FITNESS

The sexual act involves increased physical activity. Low energy levels, shortness of breath, muscle cramps, dizziness and fatigue during and after intercourse are all signs of the lack of fitness that is characteristic of many obese individuals. Because fat cells promote inflammation in the body, generalised aches and pains, stiffness and inflammation is more pronounced in the obese. Gross obesity will sometimes create major problems for partners to find a comfortable position for sexual activity.

HORMONAL IMBALANCE

Our libido or sexual interest is greatly influenced by our sex hormones - testosterone, oestrogen and progesterone to name the commonest ones. Obesity promotes hormonal imbalance in both men and women. The fat cells around the waist are not just accumulations of fat, they produce hormones, particularly the primary female hormone oestrogen.

Commonly, this creates a situation where an obese man may have very high levels of female hormones and low levels of the male hormone testosterone. This is partly because the fat cells in the belly are rich in an enzyme called aromatase that converts testosterone to oestrogen.

To make things worse, many chemicals in the food we eat, the air we breathe and common skin and hair-care products behave like estrogen. These chemicals are mainly fat soluble and accumulate in the fatty tissues in the body. All this leads to a situation where fat men are hormonally more like females, resulting in a decreased sex drive and weak erections.

Fat women may have other kinds of hormonal problems leading to menstrual disorders, infertility, ovarian cysts, excess facial and body hair, acne and painful sex.

POOR SELF-IMAGE

Research show that obese individuals are more likely to suffer from low self-esteem and poor self-worth. This kind of emotional disability does not foster good sex. Although many men find big women attractive and consider curves and love handles appealing, it is more common for partners of obese people to no longer find them sexually attractive because of their weight gain. They usually deny or suppress these feelings to prevent hurt and avoid confrontation.

In reality, however, this denial blocks communication and only harms the relationship. Clinical obesity is a life-threatening problem. Partners of obese individuals have a responsibility to help address the issue, if for no other reason than the many health dangers that obesity causes.

BOTTOM LINE

There are so many compelling reasons why we should all make the commitment to losing those excess pounds. I suggest a simple, safe, doctor recommended, nutritional approach called Cellular Nutrition. The programme comes with a personal weight-loss coach and is available all over the island. You really have no excuse.

You may email Dr Vendryes at vendryes@mac.com, visit him at www.anounceofprevention.org or listen to An Ounce of Prevention on POWER 106FM on Fridays at 8 p.m.