both weight-bearing and non-weight-bearing joints. weight loss and exercise act to reduce the risk of osteoarthritis. low back pain obese individuals are twice to four times more likely to have lower back pain than their "normal" weight peers. traumatic injury in females, low bmi is a risk factor for osteoporotic fractures in general. in contrast, obesity is a protective factor for most osteoporotic fractures. urological and nephrological urinary system urinary incontinence urge, stress, and mixed incontinence all occur at higher rates in obese people. the rates of urinary incontinence are about double that found in the "normal" weight population. urinary incontinence improves with weight loss. chronic kidney disease obesity increases one's risk of chronic kidney disease by three to four times. hypogonadism in males, obesity and metabolic syndrome both increase estrogen and adipokine production. this reduces gonadotropin-releasing hormone, in turn reducing both luteinizing hormone and follicle stimulating hormone. the result is reduction of the testis' production of testosterone and a further increase in adipokine levels. this then feeds back to cause further weight gain. erectile dysfunction obese male individuals can experience erectile dysfunction, and weight loss can improve their sexual functioning.