Rolf Degen summarizing... Obesity did not interfere with the number of sexual partners, the frequency of intercourse, or with sexual satisfaction

Sexual Satisfaction in Obese People. Monika Parchomiuk & Janusz Kirenko. Sexuality & Culture, Mar 5 2021. https://rd.springer.com/article/10.1007/s12119-021-09836-7

Rolf Degen's take: https://twitter.com/DegenRolf/status/1368157324796436481

Abstract: Obesity has numerous consequences for the psychosocial and physical functioning of the individual which most often include comorbidities, disorders, and negative social attitudes influencing self-image. These factors indirectly associate obesity with problems in the sphere of sex life. Empirical evidence on this issue is relatively unambiguous but studies that focus on the positive dimensions of sex life do not provide clear-cut conclusions. Previous studies have often been carried out in specific groups and various socio-cultural conditions. The current study analyzed the relationship between sexual satisfaction and a variable describing preferences, expectations, and needs of obese people and non-obese people. Satisfaction was analyzed taking into account two components. One reflected the degree of discrepancy/convergence between the desired and actual frequency of sexual behavior. The other reflected the degree of pleasure felt in connection with actual sexual behavior. The sample consisted of 148 obese people and 128 non-obese people. Three measures were used: the Sexual Activity Questionnaire, Sexual Stimulus Scale, and Sexual Needs and Reaction Scale. The groups did not differ significantly in terms of sexual satisfaction in either dimension. The results of the regression analysis showed a more complex structure of correlations between satisfaction, preferences, expectations, and needs in obese people compared to non-obese people. Also, the activity of the partner, including experiences during full penetration, was found to be most important for pleasure (as one of the dimensions of satisfaction) in the test group.

Discussion

The conducted cross-sectional analyses showed that obese people (BMI ≥ 30) do not differ significantly in terms of sexual satisfaction from non-obese people (BMI < 25). This applies to both of its indices: the D index showing the degree of convergence/discrepancy between the desired and actual frequency of sexual behavior and the ipsative index S reflecting the degree of satisfaction (pleasure) felt in connection with the actual sexual behavior. It is difficult to make comparisons to the results of other studies, due to different ways of conceptualizing the variable of satisfaction. Generally, though, other findings confirm the direction of the trend observed here. Younis et al. (2013) claim that obese women express a significantly lower level of sexual satisfaction than non-obese women. Bajos et al. (2010), on the other hand, suggest there are no differences in either of the sexes (compared to the control group) resulting from the BMI index. In both studies, satisfaction was assessed using questions with a ready set of answers describing different levels of satisfaction. A similar tendency, but only in women, indicating the lack of differences in sexual satisfaction (FSFI) related to BMI, was established in Polish studies (Jarząbek-Bielecka et al. 2015).

Positive trends informing about a higher level of physical and emotional satisfaction were found in obese men, compared to men in other weight categories. Obese women were also found to have sexual pleasure more frequently (Shao et al. 2015). Analysis of the results of women collected in a PISQ-12 study (assessment of sexual functioning) showed significant differences in terms of satisfaction with sexual activity to the disadvantage of obese respondents but no differences in sexual desire or the ability to achieve orgasm (Melin et al. 2008). In general, the results of present analyses are closer to the more frequent trend informing about the lack of significant differences between obese people and non-obese people or related to the BMI index analyzed as an independent variable, in terms of broadly understood sexual satisfaction.

In the first dimension of sexual satisfaction (D), there was a trend towards divergence over convergence, which in both groups can be interpreted as a feeling of partner’s insufficient (compared to the needs) sexual activity. Still, this activity provided satisfaction, as evidenced by the S index reflecting the sense of pleasure derived from various forms of sexual activity. These are two different dimensions of sexual functioning: (1) quantitative, showing the intensity of the sexual needs of the respondents in relation to the forms of partner’s sexual activity proposed in the questionnaire, (2) and qualitative expressing the personal experience derived from this activity. We did not analyze the similarities or differences in the intensity of the needs of obese people and non-obese people, but only a subjective sense of satisfaction with their implementation. The needs were assessed in the context of heterosexual partner activity. Referring to its other aspects, such as the number of intercourses or the number of sexual partners, the obtained results suggest they are convergent in both groups. These quantitative aspects of sexual functioning were also analyzed by other researchers. Various trends were observed, such as: more frequent occurrence of sexual intercourse in the group of obese women (Younis et al. 2013); significantly less frequent sexual intercourse and anorgasmia in non-obese women compared to overweight women (Morotti et al. 2013); obese women less often had a recent sexual partner, while there were no differences here between obese and non-obese men; no differences in the frequency of sexual intercourse related to BMI (Bajos et al. 2010); and no significance of BMI for the number of sexual partners in both sexes (Nagelkerke et al. 2006). In analyses involving pre-menopausal women, no differences were found related to BMI in experiencing arousal, sexual desire, or orgasm (Jarząbek-Bielecka et al. 2015).

In the current research, obese people were found to significantly differ from the control group in terms of the overall subjective assessment of partner relationships and the assessment of these relationships’ emotional component. This difference was visible not so much in the positive–negative assessment but in the varying degree of the positive assessment. In both groups, therefore, the relationships were successful and provided the respondents with positive feelings but in the case of non-obese people, the assessment reached the highest scores indicating a very high value of partner relations. Boyes and Latner (2009) established a negative relationship between BMI and the quality of marriage relationships. Respondents' assessment of their relationships was unfavorable, they reported they expected the relationship to end and they felt they did not match their ideal partner. In the present study, more people from the control group were in informal relationships, which may have affected their assessment. Formal relationships carry certain obligations resulting from living together, running a home, and having children. Their implementation, expected from the partner and undertaken by him/her, may be important for the subjective assessment of the relationship.

In addition to engaging in partner activity, most respondents from both groups, who were relatively young (compared to the average), reported to masturbate, and this was more often the case for obese people. This form of sexual need was realized at a rate comparable to that established for the general population (Bancroft, 2011).

Analyzing the sexual preferences, expectations, and needs of respondents from both groups, significant differences were noted for two factors: striving for mutual activity, and various sexual positions and fantasies, in both cases with greater intensity in the control group. Presumably, non-obese people show stronger preferences for forms of intercourse where both partners are active, they look for different ways of achieving sexual pleasure through non-classical positions and more often fantasize during intercourse. Younis et al. (2013) in a study with obese women and non-obese women found no significant differences in preferred sexual positions.

None of the factors differentiating both groups were found to be significant in the regression model for achieving sexual satisfaction, both in terms of convergence-divergence (D) and pleasure (S) in the control group. In both groups, the factor of the partner's activity during intercourse turned out to be significant in the context of satisfaction results analyzed in the D dimension. Thus, a trend was observed where the demand for specific forms of partner activity (discrepancies between the actual and desired frequency of partner’s sexual behavior) co-occurs with weaker preferences of the activity of the male partner leading to penetration and achieving orgasm this way (by both partners). This factor also proved to be important for the results of the sexual satisfaction in obese people determined by how much they experience pleasure (S). Stronger preferences of the described nature, constituting the factor analyzed here, remained in a positive relationship with the pleasure felt during sexual activity with a partner. The satisfaction of people from this group in terms of D and S indices was in a significant relationship with the factor describing the preference for foreplay activities, preceding or not leading to the sexual act. However, this factor created different patterns of connections for both satisfaction indices, because, with increased demand for partner’s sexual activity, which is not satisfied (D), there is a greater preference for staying at the stage of foreplay (kisses and hugs). In turn, greater pleasure derived from partner sex (S) was found to be associated with a lower preference for this type of activity. To sum up, the structure of the relationship between the two aspects of sexual satisfaction and preferences, expectations, and needs is richer in the group of obese people, but only the factor of the male partner activity, including experiences gained during full penetration, has a positive contribution to their sexual pleasure. In both groups, on the other hand, weaker preferences of the male partner activity, and in the case of obese people, increased preferences for foreplay, have the greatest contribution in explaining the discrepancy between the actual and desired frequency of partner’s sexual behavior. The established trends seem logical and consistent. Presumably greater sexual activity with more advanced forms is conducive to strengthening preferences of this nature, especially if the relationship with the partner provides pleasure.

In the current research, sexual satisfaction was analyzed in two ways, taking into account two dimensions: (1) quantitative—the intensity of the need to undertake certain forms of partner activity, and (2) qualitative—determining the degree of pleasure derived from this activity. Such an approach limits reductionism that is visible in the application of a single approach. The frequency of sexual intercourse, orgasms, the number of partners or even the variety of forms of sexual activity should not be essential criteria for assessing the quality of human sex life, however important they are for it (Kvalem et al. 2018). The essence of sex life is the ability to meet one’s own needs (individually differentiated) and preferences, which are shaped by many factors, both personal and social (including socio-cultural conditions). Obesity may have a more indirect impact in this respect, as stated in the introduction. The undertaken analyses do not yield unequivocal conclusions regarding the importance of obesity for sexual experiences, in their positive quantitative dimension, though. Such conclusions would be possible in longitudinal studies or retrospective analyses. Here, we can only talk about common and divergent trends in relation to the control group, which in this case were non-obese people, both in terms of individual aspects of sexual functioning and the analyzed relationships between them. Obesity occurs at different ages affecting some of the already shaped styles of psychosexual functioning, needs, preferences, and ways of implementing them in relationships or non-partner forms, or the process of their crystallization. Depending on the phase of life, it can be important for seeking and choosing a partner, building a relationship or maintaining it. The present research focused on a specific moment in the respondents’ sex life, on its current quantitative and qualitative aspects. The group of obese people studied here was selected from the population, but it was not determined how representative they were of this category. Given this limitation, it is useful to compare it with the results of non-obese people, selected on the basis of certain variables with potential significance (such as age or gender), which gives the possibility to infer about the specifics or similarities in the analyzed areas.

The limitation of the current research may be the use of self-reports but it is justified here because the needs, preferences, and expectations of the respondents were analyzed. The adopted method of data collection, used in the vast majority of studies on sexuality, may impact the accuracy of the results illustrating the quantitative dimension of the sexual functioning of the respondents, such as the number of sexual partners, the frequency of relationships or the extent of masturbation. The snowball method used for recruiting the studied group does not ensure the group’s representativeness, however, taking into account the fact that the presented study concerned intimate issues, it was a useful method for recruiting the group. Population studies are difficult here, and recruiting obese people through specialist clinics could also have disadvantages, such as attracting people who for some reason (e.g. health, image) use their services.