Introduction: Obesity is a major health concern in the United States and many developed countries. Among its many deleterious effects are those that can affect the sexual response.

Aim: To update and evaluate the state of knowledge on the possible link between obesity and sexual dysfunction.

Methods: A comprehensive search and review of biomedical, physiologic, and psychological databases were used to integrate findings on obesity, weight loss, and sexual function.

Main outcome measures: We briefly explain the two variables of interest-sexual functioning and obesity-indicating possible points of linkage. Then, we attempt to (i) describe possible direct links between obesity and sexual dysfunction; (ii) understand potential mediating biological, comorbid, and psychological factors and the interactions among such factors; (iii) discern differences in the mechanism and impact of obesity across the sexes; and (iv) review evidence suggesting that weight loss improves sexual functioning in obese individuals.

Results: The link between obesity and sexual function is complex and multivariate, with at least three different pathways likely: direct effects from adipose tissue; effects from pathophysiologic comorbidities; and effects mediated by psychological factors. In addition, effects and pathways appear to be different for men and women.

Conclusion: We conclude by identifying some existing challenges for the study of obesity and sexual function, specify areas that warrant further investigation, and reiterate the potential value of encouraging obese patients to consider weight loss as a path toward a healthier and more sexually satisfying life. Rowland DL, McNabney SM, Mann AR. Sexual Function, Obesity, and Weight Loss in Men and Women. Sex Med Rev 2017;5:323-338.