Men and women with obesity face distinctly different hidden health risks, with men more likely to accumulate dangerous belly fat while women show higher levels of inflammation and cholesterol, according to new research presented at this year’s European Congress on Obesity (ECO) in Istanbul, Turkey.
The findings, which could pave the way for more personalized, sex-based treatment strategies, reveal that obesity does not affect all individuals equally. A research team from Dokuz Eylul University in Turkey analyzed data from 886 women and 248 men treated at the university’s Obesity Clinic between 2024 and 2025, uncovering significant differences in fat distribution, metabolic markers, and inflammatory responses.
Men: Higher Risk of Visceral Fat and Liver Damage
Men with obesity in the study were found to be more likely to accumulate abdominal visceral fat, the type of fat that surrounds internal organs and is strongly linked to serious heart and metabolic conditions. Although men had only a slightly higher body mass index (BMI) than women (37.5 vs. 36 kg/m²), their waist circumference was substantially larger at 120 cm compared to 108 cm for women. Men also had significantly higher systolic blood pressure (128 vs. 122 mmHg).
Additionally, men showed elevated levels of liver enzymes, including alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), as well as higher triglycerides and creatinine. These markers point to a greater likelihood of liver-related complications and metabolic disorders.
Women: Higher Inflammation and Cholesterol Levels
Women with obesity, in contrast, experienced higher total cholesterol (215 vs. 203 mg/dL) and higher low-density lipoprotein (LDL) or “bad” cholesterol (130 vs. 123 mg/dL). They also demonstrated elevated inflammatory markers, including C-reactive protein, erythrocyte sedimentation rate, and platelet count. These patterns suggest a stronger systemic inflammatory response, which raises the risk of heart disease and type 2 diabetes.
Hormones and Biology Explain the Divide
According to lead author Dr. Zeynep Pekel, from Dokuz Eylul University in Izmir, Turkey, these differences are likely influenced by hormones, immune system activity, and how fat is distributed in the body. Estrogen affects fat storage and inflammatory responses, with women typically storing more fat beneath the skin while exhibiting higher levels of inflammation-related markers. Women also generally have a more active immune response, partly due to genetic factors such as the X chromosome.
“Our findings reveal intriguing differences in the way men and women respond to obesity,” said Dr. Pekel. “They show just how important gender-specific research is. Not only are sex differences a powerful player in the pathology and course of obesity, but our results indicate that such differences could be a stepping stone toward finding targeted, sex-based therapies to help in the management of people living with obesity.”
A Global Health Challenge
The research comes amid a growing global obesity crisis. In 2023, approximately 1.54 billion adults worldwide were living with metabolic syndrome, a cluster of risk factors including abdominal obesity, high cholesterol, high blood pressure, and raised fasting plasma glucose. The condition affects about one in three women and one in four men globally.
Limitations and Next Steps
The researchers note that the study is cross-sectional, meaning it cannot determine cause and effect, and most participants were adults of Turkish ethnicity, so findings may not fully apply to other populations.
“It’s still early days and these findings need to be confirmed in other patient groups, but they offer important insight into how obesity may affect men and women differently,” said Dr. Pekel. “Our next steps are to validate these findings in larger populations, better understand the biological processes behind these differences, and explore how these patterns relate to clinical risk.”
The research was presented at the European Congress on Obesity (ECO), held May 12-15 in Istanbul, and has not yet been published in a peer-reviewed journal.