Treatment of Obesity-Related ED (Erectile Dysfunction) in Men

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

New York Urology Specialists offer the most effective treatment options for men with ED caused by obesity, diabetes, and hypertension.

Causes of Obesity in Men

Obesity and EDWith the advancement of technology, men are becoming less physically active, and are spending more and more time in front of computers, cell phones, and televisions.

 While we see a lot of men physically active when they are in their 20’s, the stress of life leads to less physical activity for many men as they age.

Diet high in fat, carbohydrates and fried foods contribute to the obesity epidemic  Obesity is a medical term used to describe people with a BMI (body-mass-index) over 30.

What are the Dangers of Obesity?

Many urological diseases are associated with obesity including hypogonadism (low testosterone), erectile dysfunction, kidney stones and prostate cancerHeart disease, diabetes mellitus type II, high blood pressure, metabolic disorders, many other diseases all owe a debt of gratitude to obesity.

Erectile Dysfunction and Obesity

Erectile dysfunction has long been associated with obesity.

Obesity generally causes insulin insensitivity in the body which in turn leads to high blood glucose levels, a pre-diabetic state. Over time, high glucose levels (diabetes) causes damage to blood vessels that carry blood to the penis.  Diabetes also causes damage to nerves that innervate the penis and facilitate erections.

Another important mechanism that plays a role is the hyperlipidemia or increased blood cholesterol levels associated with weight gain. Elevated cholesterol is responsible for deposition of lipids in the walls of vessels, leading to their blockade. This reduces blood supply to vital organs of the body.  In the case of erectile dysfunction, the penile artery or one of the arteries that bring blood to the penile artery get affected. Blood flow is crucial for erections to occur.

Obesity can also lead to low testosterone levels or abnormal testosterone/estrogen balance which can also affect erection quality.

As important, obesity can be a cause of high blood pressure in men, which damages blood vessels, including penile blood vessels.

How Obesity Leads to Problem with Getting and Keeping Erections (erectile dysfunction)?

Erection in a normal male results from sexual stimulation or visual stimulation.  Erection is controlled directly by the brain. The brain receives a stimulus which can be in the form of visual, auditory or tactile sexual stimulation. These are then processed in the brain, with subsequent impulses sent to the penis where it leads to an erection. So for an erection to take place, the nervous system, blood vessels, and smooth muscles, should all be healthy.

Damage to blood vessels and nerves can lead to erectile dysfunction because both of these are important to achieve and maintain good erections in males.  Obesity can damage blood vessels directly by causing atherosclerosis (high cholesterol), high blood pressure.  It can damage the nerves by increasing risk of diabetes which damages nerves and blood vessels.

Symptoms of Obesity-Related Erectile Dysfunction

Symptoms of erectile dysfunction or impotence usually start appearing slowly over time. It starts initially as partial dysfunction such as occasional difficulty obtaining or maintaining a sufficiently hard erection. Over time, men can completely lose the ability to obtain an erection.

Treatment Options for Overweight Men with Erection Problems

Obesity-related erectile dysfunction is treated by focusing initially on obesity itself. Research has shown that losing weight can reverse erectile dysfunction during the initial stages.

At New York Urology Specialists, we advise simultaneous treatment for ED with medications to help men get adequate erections fast and stay motivated and non-medical approaches such as weight loss and dietary changes, which can take time to work.

Weight loss can be achieved reasonably fast by lifestyle and dietary modification. Regular exercise is important for good health. Similarly, diet modification is also essential. Foods rich in refined sugars, carbohydrates and fats should be avoided. A consultation with a dietician is often beneficial.  Fruits, vegetables, proteins and omega 3 are good dietary options.  Medications that can help men lose weight are also available by prescription.  Few people truly realize what they eat and how many calories different foods in their diet contribute.


To work-off one BigMac meal, you need to run NON-STOP about 1-1.5 hours (1 mile in 10 minutes). You need to run 10 miles to run off a Big Meal.  You burn about 130-150 calories an hour running 1 mile in 10 minutes.

Total Meal calories:  BigMac Meal: 1180 calories   Double Quarter Pounder Meal: 1420 calories

BigMac 540 calories
Double Quarter Pounder® with Cheese 780 calories
Coca-Cola Large 300 Calories
World Famous Fries medium 340 Calories

Recommended Daily Intake Calories:  Around 2,000 calories.

Losing weight is not easy. It takes a lot of motivation and consistency. It usually takes more than 6 months to achieve a target weight. If erectile dysfunction persists after weight loss, then other treatment options can be employed.  If ED is severe, these options can be tried earlier. Physical exercise can help maintain better erections.

Treatment of Testosterone Deficiency in Overweight and Obese Men

Correction of testosterone deficiency, when present, can also help with weight loss.  Studies show that in men with low testosterone and obesity, treatment of low testosterone levels can help with weight loss.  In addition, testosterone replacement therapy can help with improving erection quality.

Help with Getting and Keeping Erections Hard in Men Who are Overweight or Obese

Medications used for treating ED: Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) are effective for men who are obese.  Medications should be used in combination with treatment focused on weight loss, diet modification and control of high blood pressure and diabetes when these diseases are present.

If oral pills such as Viagra or Cialis do not work well, medications may be directly injected into the penis with a tiny needle and minimal discomfort. Prostaglandins such as alprostadil (prostaglandin E) are effective in bringing about smooth muscle relaxation and hence, an erection. It is effective in 70-80% of patients.

A Vacuum Erection Device or VED is another treatment option.

Effective Surgical Treatment for Erectile Dysfunction

For men who cannot tolerate medications or other non-surgical treatment options, a penile implant is a very effective treatment option.  An inflatable penile prosthesis is another good option for men who cannot take medications.  It has a high success rate and can be done with a small scrotal incision.

Weight loss prior to penile implant surgery is helpful to get the penis to appear larger when erect.  Some men may require abdominoplasty to remove excess skin and fat.

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If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido. We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts in the USA, Canada, South America and the Caribbean and other international patients. We also offer emergency care for men with urological problems.