Good health is closely tied to sexual health. A healthy diet and exercise that result in a normal weight form the foundation of sex drive and functioning (Frisch et al, 2011). For example, obese men and women tend to report low sexual quality of lif (0stbye, 2011). Body fat, especially around the abdomen, reduces testosterone level in men. A high waist circumference and low levels of physical activity are associatec with increased likelihood of having erectile disorder (Janiszewski et al., 2009). A stud] of more than 22,000 healthy men over 14 years found that men who were obese wen 90% more likely to develop erectile disorder. In contrast, men with the highest exercisi levels were 30% less likely than other men to develop ED (Bacon et al., 2006).

Avoiding the use of tobacco and recreational drugs is another health habit that cat contribute to sexual functioning. For example, women who do not smoke, who have ; history of moderate or less alcohol use, and who are a healthy weight are much less likeh to have sexual dissatisfaction and disorders than those with the opposite characteristic (Addis et al., 2006). Tobacco use can have a dramatic negative effect on male sexua functioning: Men who smoke are twice as likely to have erectile difficulties than met who do not smoke (Harte & Meston, 2008a). In one study, even nonsmoking womei who used nicotine gum experienced decreased sexual arousal (Harte & Meston, 2008b) ■ Table 14.4 lists other recreational drugs that can impair sexual functioning. •