The objectives of our study was to appreciate the impact of weight overload on the sexuality of a population of obese subjects compared to a control group, and to identify, in obese subjects, factors linked to sexual dissatisfaction.

The study involved subjects whose body mass index (BMI) was greater than or equal to 30kg/m2, recruited from the outpatient consultation of Endocrinology at the University Hospital Hedi Chaker Sfax in Tunisia. The control group, matched for age, sex and level of education, was recruited at the same consultation among the companions of consultants, whatever the diagnoses.

The average BMI of obese patients was 33.48kg/m²; that of controls was 23.27kg/m2. The dissatisfaction with the body image was more frequent in the obese group than in control group (50% versus 27.5%, P=0.039). In the population of obese subjects: sexual satisfaction was correlated with positive perception of an attracting body (P=0.015); sexual desire was correlated to satisfaction with body image (P=0.019); sexual pleasure was correlated with perception of an attracting body (P=0.016); avoidance of sexual intercourses was significantly related to dissatisfaction with body image (P=0.025).

Our study showed a clear link between obesity and sexual dissatisfaction, and between satisfaction with body image and sexual fulfillment. Therefore, sexual satisfaction should be systematically appreciated in obese patients. Sexological approach, if needed, would allow to improve the management of such patients.