Obesity risks differ between sexes

Obesity is often viewed as a single global health problem, but growing evidence shows it does not affect everyone in the same way.

Recent research led by Dr Zeynep Pekel at Dokuz Eylul University in Turkey highlights striking biological differences in how obesity impacts men and women, with important implications for diagnosis and treatment. 

The study, to be presented to the European Congress on Obesity in May 2026, analysed cardiometabolic and inflammatory markers in more than 1,100 adults with obesity. 

While body mass index (BMI) was broadly similar between sexes, the underlying health risks diverged significantly. 

One of the clearest differences was fat distribution. Men with obesity were far more likely to accumulate visceral fat – the deep abdominal fat that surrounds internal organs. This type of fat is strongly associated with insulin resistance, cardiovascular disease, and fatty liver disease. 

In line with this, men in the study showed higher levels of liver enzymes, signalling greater stress on the liver and increased risk of metabolic complications.

Women with obesity, in contrast, displayed a different risk profile. They were more likely to experience systemic inflammation and an unfavourable blood lipid profile, including higher total and LDL (“bad”) cholesterol.

These factors substantially increase the risk of heart disease and type 2 diabetes, even when visceral fat levels are lower than those seen in men. 

Researchers believe these differences are driven by a complex interaction of hormones, immune function, and adipose (“fatty”) tissue biology. 

Oestrogen influences how and where fat is stored and may promote inflammatory pathways, while testosterone appears to play a role in visceral fat accumulation and liver metabolism. 

As Dr Pekel notes, biological sex is “a powerful player in the pathology and course of obesity”. 

These findings challenge the idea of a “one‑size‑fits‑all” approach to obesity management. Current clinical assessments often rely heavily on BMI, which can mask sex‑specific risks. 

The study suggests that men may benefit from closer monitoring of liver health and abdominal fat, while women may require more aggressive management of inflammation and cholesterol levels.  

Ultimately, Dr Pekel’s research points toward a future of sex‑specific obesity treatment, where prevention strategies and therapies are tailored to the distinct biological risks faced by men and women.

Related reading: Science Daily, Medical Express, Eureka Alert