To evaluate the impact of the perception of body image on sexual activity of obese patients compared to a sample from the general population.

A cross-sectional case-control study. It involved 40 obese married patients (BMI ≥ 30 kg/m2) and 40 normal weight subjects of the general population. A questionnaire was presented with sociodemographic data, somatic and psychiatric personal histories and data on obesity. Besides, there were seven items assessing perception of body image and five items assessing the impact on sexuality.

The sex-ratio (men/women) of obese patients was 0.53. Obese women were less frequently satisfied with their body image than men (p = 0.002). Obese subjects were statistically more dissatisfied with their bodies than controls (p = 0.039). In Obese patients, avoidance of sexual intercourse was significantly related to dissatisfaction with body image (p = 0.025) and to the perception of unattractive body (p = 0.026). Sexual satisfaction was statistically correlated with the perception of a positive attracting body (p = 0.015). Sexual desire was statistically correlated to the satisfaction of body image (p = 0.019), positive perception of an attractive body (p = 0.017) and positive perception of a youthful body (p = 0.041). Sexual pleasure was correlated with the perception of an attractive body (p = 0.016).

The stigmatization of obese subjects leads to a weakening of the healthy perception of body and might be an obstacle to sexual fulfillment.