On the CBS sitcom “Mike & Molly,” the title characters meet at an Overeaters Anonymous support group and embark on a romantic relationship.It’s an uncommon look at intimacy between plus-sized partners, played mainly for laughs. But with obesity rates skyrocketing in this country, sex when one or both partners are heavy is becoming a very real issue.Nearly 34% of American adults are obese, according to the CDC, and many more are overweight. It’s not surprising that people who are carrying extra pounds may find themselves grappling with the effects on their sex lives.Being overweight or obese can put a damper on things in the bedroom, as my clients Tom and Laura discovered. Married for 12 years, they had always enjoyed a satisfying sex life - until Laura began to gain weight. At first Tom was understanding: He knew that Laura’s self-esteem had taken a hit and he didn’t want to add to that.When they came to see me after many sexless months, however, Tom finally admitted that he was having trouble finding Laura as attractive as he once had.Whether you’ve always been heavy or have just put on weight over the years, you may notice that your sex life is going downhill. A recent study of moderately to severely obese people, published in the “Journal of Sex and Marital Therapy,” found that these men and women reported being less satisfied than the general population.Another study, by researchers at Duke University, found that up to 30% of obese people who sought help controlling their weight did so due to problems with their libido, sex drive, and/or sexual performance.While self-esteem may play a role, it’s not the only factor involved. Conditions such as high cholesterol, high blood pressure, and diabetes often accompany obesity and can impair blood flow to the genitals, resulting in problems with erectile dysfunction in men and arousal in both men and women. Extra weight can also stress the knees and other joints, making some sexual positions uncomfortable.Of course, not everyone who is overweight is in poor health or unfit. Some research even suggests that heavier people may enjoy a few extra benefits in the bedroom: A 2008 study in “Obstetrics & Gynecology” looked at more than 7,000 women and found that those who were overweight were actually slightly more likely to report having had sex with men than their slimmer counterparts.Another study found men who are overweight are less likely to have premature ejaculation and tend to last longer in bed—7.3 minutes, compared to just 103 seconds for thinner men. This difference is possibly because heavy men typically have higher levels of the female sex hormone estradiol, which delays climax.It’s absolutely possible to enjoy a satisfying sex life whether you weigh 130 pounds or 330 pounds. If you’re overweight and struggling to keep things steamy, though, it’s time to take action. That doesn’t have to mean going on a diet, although shedding just 10 pounds can stimulate sex hormones and improve health.Try a new position: Experiment with positions that take the weight off your joints (and your partner): Try spooning side by side, rear entry, and modified missionary positions with pillows under the female partner’s hips.Enjoy intimacy: Sex isn’t just about intercourse. Explore other forms of intimacy, including oral sex, manual stimulation, toys, and even just kissing and cuddling.Think outside the box: It may sound silly, but my clients Tom and Laura reclaimed their sex lives with a simple flick of the switch. The next time they made love, they dimmed the lights and relied on the power of fantasy to carry them both over the edge. Now they’ve discovered a new found excitement in the bedroom that has nothing to do weight.Read up: There are a growing number of resources for couples in which one or both partners are overweight. The book “Big Big Love: A Sourcebook on Sex for People of Size and Those Who Love Them” by Hanne Blank does a great job of dispelling myths, helping readers boost self-esteem, and offering detailed information about sexuality.So remember, being overweight doesn’t mean your sex life is over. With a little creativity and a few adjustments, you can get - and stay - satisfied.