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Dear Drs. Gail and Lewis Wyatt:

My boyfriend and I weigh almost 560 pounds together. We have a great time exercising and cooking together, but neither one of us ever read anything about sex when people can’t really see their genitals. He has a hidden penis that I have never seen. It is buried under his fat stomach. Sex is such an effort that he prefers anal sex. I go along with it because of our weight, but I think that I want to see and feel his penis. I wonder if it’s big because he is bigger? I also worry if we will be able to have children and have sex like everybody else. And I’d love to be able to cuddle with him. —Anika M.

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You have raised some really important issues, and we are happy that you wrote. Almost 2 out of 3 Americans are overweight, and obesity has long-term effects on your physical and mental health. Reaching and maintaining your weight is a critical life goal. We were also delighted to hear that you are cooking and exercising together. There are lots of coaches and classes for nutrition and weight maintenance that you may want to consult to make sure that you are doing the right things and have weight-loss goals that you reach.

If you are thinking about or having sex, you need to see each other’s genitals or sex organs and make sure you’re healthy and ready for sex. Shower first and dry off, even if you have to lift skin to make sure that no area remains wet, and have a nice-sized mirror nearby. Lie on the bed and have him hold the mirror so that you can look at your vagina, clitoris and all the parts that you might not see if you were standing up.

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Look at the color first. You are color-coded, so if your skin is brown, you would expect your genitals to be brown. You may want to consider getting the hair around your genitals waxed off so that you can more easily see if your vagina is healthy. If you see or feel pinkish or red areas or bumps stretching from your vagina to your bottom, you may need to go to the doctor and be examined for any infections, including HIV and other sexually transmitted diseases.

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Once you’ve seen yourself, it is easier to guide your partner to areas that like to be touched. Encourage your partner to wash and look at himself, too, with you holding the mirror. He also needs to get tested for any sexually transmitted infections and HIV. Now you have the chance to see and touch his penis.

The penis does not grow when a person gains weight. Depending on whether he has been circumcised or not, a hidden or concealed penis is usually normal but is lying under body fat. The penis can usually be exposed by pressing back on the surrounding skin. His sexual functioning should not be affected by weight gain. If you are concerned about the health of his sperm and having a family some day, raise this issue when you go to the doctor with him.

As you lose weight, there are other health issues that may need a doctor’s care to minimize. Now that you two have established a pattern of going to the doctor together, if there is something that concerns you, that is the time to ask those questions.

You should be having sex that will give you pleasure and not just what requires less effort. If there is a reason to reach your weight-loss goals, increasing your sexual pleasure is it.

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You may also need to try different positions that allow your genitals to touch and meet. Tell your partner about your need to cuddle, and do all that you can to get your needs met. Sex is great when both of you can fully enjoy each other.

For answers to your questions about sexual health, write to us at justsex@theroot.com. Be sure to include your age, gender, any medications you’re taking and the nature of your sexual problem.

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Gail Wyatt, Ph.D., is a licensed clinical psychologist and sex therapist. She is also a professor at UCLA and director of the university’s Sexual Health Program. Lewis Wyatt Jr., M.D., is a board-certified obstetrician-gynecologist in private practice in Beverly Hills, Calif. He specializes in sexual health and bioidentical hormone treatment.