When it comes to erectile dysfunction, sleep is often an overlooked factor, says Petar Bajic, director of men’s health at the Cleveland Clinic’s Glickman Urological Institute. Testosterone is made during deep sleep, and low testosterone is sometimes the culprit for a low sex drive.
“People who are heavier are more likely to have sleep disorders like sleep apnea, and if you have sleep apnea, you don’t get the deep and restful stages of sleep,” he says. “Your oxygen levels are dropping, and it prevents you from going into REM sleep, which is the deep and restful stage of sleep during which testosterone is produced.”
Zepbound, made by Eli Lilly, was approved by the US Food and Drug Administration in December as the first medication to treat obstructive sleep apnea.
The modest amount of weight Desmond has lost on Wegovy so far probably doesn’t explain his recent boost in libido. But the fact that he’s eating less may have something to do with it. “When I overeat, I’m out of the game for a couple hours. I just feel gross. My body’s digesting,” he says. “I’m sure that could have an effect on libido and our ability to do sexual things that require activity.” Most of us don’t feel particularly attractive after eating a large meal.
For Julie, who didn’t want her last name used for privacy reasons, GLP-1 medications haven’t changed her libido but have had a positive effect on her sex life in a different way. The 47-year-old started Wegovy in March 2023 and switched to Zepbound in August last year. Her “food noise,” or inner chatter about eating, has also decreased, and she has lost about 60 pounds, down from a starting weight of 276.
The weight loss has made her feel more physically comfortable in the bedroom, making sex with her husband more enjoyable. “If I’m on top, and I have weight resting on my knees or hips, it doesn’t hurt as much,” she says. “If I’m on all fours, my wrists don’t hurt from holding myself up, which makes everything better.”
Certain positions are quite literally a better fit now, she says. And the weight loss has made her more open to trying or suggesting those positions.
The reality is, sex drive and sexual interactions are complicated, says Jessica Borelli, a clinical psychologist at UC Irvine, who focuses on the links between close relationships, emotions, health, and development. They are in part determined by arousal, which has a physiological component, but also by relationship dynamics and psychological factors, she says. And of course, physical comfort during sex plays a role.
Borelli says that when people lose weight, they may feel more confident about themselves or have higher energy levels. But they may also be viewed or treated differently by their partners and others, especially if there’s substantial weight loss. For instance, they may be sexualized or objectified in a way they’re not used to. “People aren’t always ready for how that’s going to feel,” Borelli says.
Weight loss can change relationship dynamics in other ways. If one partner has lost weight and the other hasn’t, that could cause insecurity in the other person if they also want to lose weight. A person’s preferences in hobbies and interests can also change after weight loss, which can disrupt the typical patterns and rhythms of a relationship. For instance, if the person who lost weight is suddenly motivated to exercise more or forgo alcohol when they used to have lazy weekends with their partner or drink together as a couple, that could create tension.
