Deep Dive

Why Your Tight Toolbelt May Prevent Peak Performance

Diagnosing Engine Problems When the Horn Stops Working

These words from a recently retired man in his late 60s capture what I hear almost daily.

He wasn't sick. Just tired. Unmotivated. And worried about his changing sex life.

I'm not a weight-loss specialist. But I see countless men – especially around retirement – who discover that excess weight is affecting their sexual health in ways they never anticipated.

After decades of powering through careers, family responsibilities, and putting everyone else first, they finally have space to look at their own health more intentionally.

And what finally brings them through my door isn't usually heart concerns or concerning lab results.

It's sex.

Low libido. Sluggish erections. Diminishing confidence.

By the time they reach my office, most have already tried the basics – eat better, move more, "just try harder." 

That kind of simplistic advice rarely works. It oversimplifies a complex situation and adds shame to something already deeply personal.

That conversation with my retired patient turned into a much broader reset for him. Not overnight, but over time – addressing not just symptoms, but the whole person.

Because this isn’t about becoming thin or chasing six-pack abs.

It’s about becoming someone who takes care of themselves – physically, emotionally, and sexually.

Not “I don’t eat chips anymore,” but maybe, “I don’t eat chips after 7 p.m., and I always put them in a bowl.”

Small choices, made consistently, shift identity.

And that’s what actually sticks.

Troubleshooting Weight and Performance Problems

Obesity increases the risk of erectile dysfunction (ED) by 30–90%.

Harvard Medical School researchers found that men with a 42-inch waist were twice as likely to have ED as men with a 32-inch waist.

But it’s not just about blood flow. It’s hormonal, metabolic, and vascular.

Here's what happens inside your body when weight increases:

• Energy, sleep, and confidence all take a hit

• Estrogen rises – fat tissue converts testosterone to estrogen

• Testosterone drops – especially as visceral fat (the “hard belly”) builds

• Insulin resistance and inflammation disrupt hormones and blood vessels

This isn’t just about how you look. It’s about how your body works – and how that impacts desire, performance, and self-perception.

Early Warning Signals Your Body Sends First

The blood vessels in the penis are some of the smallest in the body – and often the first to show signs of damage from inflammation or metabolic dysfunction. 

ED isn’t just frustrating – it’s often the first sign of deeper vascular risk.

Visceral fat – the firm fat around the organs – isn’t just extra weight. It actively disrupts hormones, increases inflammation, and impairs blood flow. 

And you don’t have to look out of shape to carry it – many men with normal weight or solid habits still have hidden risks.

So even if sex is what starts the conversation, we always recommend:

• Evidence-based screening (blood pressure, A1c, insulin, lipids, testosterone)

• Annual health maintenance

• Looking beyond symptoms to what’s driving them

Because addressing ED now isn’t just about performance.

It may prevent something far more serious later.

Small Upgrades with Powerful Performance Results

Here’s what often gets missed:

You don't need to completely overhaul your life or lose massive amounts of weight.

• Losing just 5–10% of body weight can improve insulin sensitivity, lower inflammation, and raise testosterone by 100–200 ng/dL

• Men in this range often report stronger erections, more energy, and better mood – even before major physical changes are visible

For a 202-pound man, that’s just 11-22 pounds – about what many men gain over a holiday season.

These early wins can unlock motivation.

You feel better, so you do more. That’s momentum.

Building a Complete Performance Toolbox

There's no one magic solution that works for everyone. What you need is a complete toolbox of options that you can customize for your body.

Every craftsman knows different jobs require different tools. Your body works the same way.

Here are the essential tools for your performance toolbox:

Nutrition

Why: Eat more protein. Less processed food. A routine that fits your life.

Real Talk: A registered dietitian can help simplify, not restrict.

Strength Training

Why: Muscle supports testosterone.

Real Talk: Just 2–3 sessions a week is enough to shift energy, glucose, and body composition.

Sleep

Why: You make testosterone while you sleep.

Real Talk: Aim for 7–8 hours. If you snore or wake up tired, get evaluated for sleep apnea.

GLP-1 Medications

Why: Drugs like semaglutide or tirzepatide help regulate appetite and insulin resistance.

Real Talk: Not a shortcut – just one more tool that works well for the right person, particularly those with obesity or insulin resistance.

Testosterone Therapy

Why: TRT can help – but only if your levels are low, and only when paired with lifestyle.

Real Talk: It doesn’t fix everything. It helps other changes work better.

Mindset & Mental Health

Why: Stress, shame, and burnout take a toll – not just on mood, but on libido and energy.

Real Talk: Therapy, coaching, or a real conversation about what’s going on can make a difference.

Stress Management

Why: Chronic stress raises cortisol, lowers testosterone, and stores fat around the waist.

Real Talk: Daily movement, breathing, unplugging – it adds up. 

The Buddy System Accountability

What: Change sticks better with support – whether that’s a partner, friend, or professional.

Real Talk: Reach out to that friend and create an accountability text thread. Check in daily.

Metabolic Screening

Why: Don’t guess. Labs help you understand what’s hormonal vs. metabolic.

Real Talk: Test total/free testosterone, A1c, fasting insulin, lipids, hs-CRP, and Lp(a) if family history is strong.

Retirement as Your Performance Rebuilding Phase

This stage of life doesn’t have to be about slowing down.

It can be about getting stronger, sharper, and more in control of your health.

Not to rewind the clock.

But to move forward as someone who consistently chooses things that support their body, goals, and relationships.

Taking care of your health isn't about becoming someone new.

It's about returning to yourself and showing up fully for the life you want.

Sex might be the symptom that brings you through my door.

The outcome is regaining control of your health, your confidence, and your future.

Your Seven Day Performance Improvement Project

You don't need to rebuild your entire life this week. Start with just one powerful change:

THIS WEEK: Choose your entry point

• Get your numbers: Schedule a testosterone, A1c, and metabolic panel test

• Move daily: Walk 10 minutes after dinner (no equipment, no gym required)

• Sleep better: Set a consistent bedtime for the next 7 nights

THIS MONTH: Have the conversation you've been avoiding

• With your doctor: "I want to discuss how my weight affects my sexual health"

• With your partner: "I'm making some changes to feel better and have more energy"

• With yourself: "What's one habit from my younger days I actually enjoyed?"

Remember: This isn't about perfection. It's about momentum.

One tool at a time. That's how change sticks.

Next Steps: What one habit made you feel strong and capable in your younger days? 

Can you bring back a modified version this week?