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	Since this article does not have an abstract, we have provided the first 128 words of the full text and any section headings.

To the Editor: Dr Esposito and colleagues¹ report that caloric restriction and increased physical activity led to weight loss, a decrease in markers of inflammation, and improvement in erectile function in obese men with erectile dysfunction. The authors suggest that this improvement may relate to changes in endothelial function, an idea that is also addressed in the accompanying editorial by Dr Saigal.² In the same issue of JAMA, Dr Morgentaler³ discusses the important interactions between testosterone and erectile function. Obesity is also associated with decreased levels of testosterone and free testosterone, and increased peripheral conversion of androgens to estrogen.^4-5 Given this, it would be helpful to know if Esposito et al measured testosterone levels, and, if so, whether there was a change related to weight loss.

David H. Sarne, MD
dhsarne@uic.edu
University of Illinois Medical Center
Chicago

1. Esposito K, Giugliano F, DiPalo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men. JAMA. 2004;291:2978-2984. FREE FULL TEXT 2. Saigal C. Obesity and erectile dysfunction: common problems, common solution? JAMA. 2004;291:3011-3012. FREE FULL TEXT 3. Morgentaler A. A 66-year-old-man with sexual dysfunction. JAMA. 2004;291:2994-3003. FREE FULL TEXT 4. Glass AR, Swerdloff RS, Bray GA. Low serum testosterone and sex-hormone binding globulin in massively obese men. J Clin Endocrinol Metab. 1977;45:1211-1219. ISI | PUBMED 5. Schneider G, Kirschner MA, Berkowitz R. Increased estrogen production in obese men. J Clin Endocrinol Metab. 1979;48:633-638. ABSTRACT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:2467.

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